Tfh细胞相关因子CXCL-13在小细胞肺癌中的作用及临床意义

doi:10.3877/cma.j.issn.1674-6902.2017.02.013

目的

探讨Tfh细胞的趋化因子CXCL-13与SCLC发病及进展的相关性。

方法

随机收集28例SCLC患者(SCLC组)和38例健康人(对照组)的临床资料和外周血样本，采用ELISA法检测小细胞肺癌(SCLC)患者外周血中滤泡性辅助性T细胞(follicular helper T cells, Tfh)的趋化因子CXC基元配体-13(chemokine C-X-C motif ligand-13, CXCL-13)表达水平，结合临床资料按照性别、年龄、吸烟情况及肿瘤分期进行亚组分析，明确各相关因素与SCLC的关系。

结果

SCLC组CXCL-13(55.36±5.293)ng/L明显高于对照组(28.71±2.671)ng/L，P<0.0001；在SCLC组中年龄、性别及吸烟史差异对CXCL-13表达没有显著差异：男性(53.52±5.759) ng/L、女(64.59±14.08) ng/L，P＝0.4995；年龄<55岁(50.08±6.945)ng/L、年龄≥55岁(58.01±7.184) ng/L，P＝0.4347;吸烟<200年支(62.59±8.975) ng/L、吸烟≥200年支(68.09±4.128) ng/L，P＝0.5854。而在SCLC组与对照组的对比中，各因素对CXCL-13的表达均有一定的影响，女性(9.976±1.534 ng/L，64.59±14.08 ng/L，P＝0.0028)，男性(31.07±3.778 ng/L，53.52±5.759 ng/L，P＝0.0023)；年龄<55岁(27.77±2.987 ng/L，50.08±6.945 ng/L，P＝0.0121)，年龄≥55岁(31.75±6.096 ng/L，58.01±7.184 ng/L，P＝0.01)；吸烟<200年支(28.15±2.723 ng/L，62.59±8.975 ng/L，P＝0.0028)；吸烟≥200年支(28.86±7.312 ng/L，68.09±4.128 ng/L，P＝0.0005)。SCLC组中，不同肿瘤分期的CXCL-13表达有显著差异，(31.07±2.37 ng/L，57.18±5.919 ng/L，P＝0.0003)。

结论

在SCLC患者的外周静脉血中CXCL-13的表达水平与健康对照组有显著差异，且与性别、年龄、吸烟情况有密切关系，同时肿瘤分期越晚的患者，其CXCL-13的表达水平越高。CXCL-13作为Tfh的趋化因子，对SCLC的早期临床诊断和预后判断有潜在的临床意义。

关键词: 小细胞肺癌, CXCL-13, Tfh, 临床意义

Objective

To detect expression levels of follicular helper T cells (follicular helper T cells, Tfh) chemokine C-X-C motif ligand-13 (CXCL-13) in small cell lung cancer (SCLC) patients and healthy human peripheral blood, to investigate the interaction between Tfh cells chemokine CXCL-13 and SCLC in the pathogenesis and progression.

Methods

It was randomly collected that the clinical data and peripheral blood samples of 28 cases of SCLC patients (SCLC group) and 38 healthy people (control group), Tfh cell chemokine CXCL-13 was detected by ELISA assay in peripheral blood, combined with clinical data, according to gender, age, smoking status and tumor stage subgroup analysis, clear the relationship between the related factors and SCLC.

Results

SCLC group CXCL-13 (55.36±5.293) ng/L was significantly higher than the control group (28.71±2.671 ng/L), P<0.0001; in the SCLC group, age, sex and smoking history differences on the expression of CXCL-13 had no significant difference: male(53.52 ± 5.759) ng/L, female (64.59 ± 14.08) ng/L, P=0.4995; aged <55 years old (50.08±6.945)ng/L, aged≥55 years old (58.01±7.184)ng/L, P=0.4347; smoking<200 years (62.59±8.975)ng/L, smoking≥200 years (68.09±4.128)ng/L, P=0.5854. And in contrast to the SCLC group and the control group, the influencing factors on CXCL-13 expression were female (9.976±1.534, 64.59±14.08 ng/L, P=0.0028), male (31.07±3.778 ng/L, 53.52±5.759 ng/L, P=0.0023); age<55 (27.77±2.987 ng/L, 50.08±6.945 ng/L, P=0.0121), aged≥55 years old (31.75±6.096 ng/L, 58.01±7.184 ng/L, P=0.01); smoking<200 years (28.15±2.723 ng/L, 62.59±8.975 ng/L, P=0.0028); smoking≥200 years (28.86±7.312 ng/L, 68.09±4.128 ng/L, P=0.0005). In the SCLC group, the expression of CXCL-13 in different tumor stage had significant difference(31.07±2.37 ng/L, 57.18±5.919 ng/L, P=0.0003).

Conclusions

The expression level of CXCL-13 in patients with SCLC in peripheral blood were significantly different from those of the healthy control group, and gender, age, smoking status are closely related, and the later stage of tumor patients, the CXCL-13 expression level is higher. CXCL-13, as a chemokine of Tfh, has potential clinical significance in early diagnosis and prognosis of SCLC.

Key words: Small cell lung cancer, CXCL-13, Tfh, Clinical significance

图1 SCLC组和健康对照组的CXCL-13的表达水平的比较

图2 SCLC组与健康对照组各亚组CXCL-13表达水平的比较

图3 CXCL-13的表达与肺癌分期的关系

表1 不同肿瘤分期病人两两检验P值表

Ⅰ	Ⅱ	Ⅲ	Ⅳ	?
Ⅰ	－	－	－	－
Ⅱ	－	－	0.8535	0.2365
Ⅲ	－	0.8535	－	0.1086
Ⅳ	－	0.2365	0.1086	－

表1 不同肿瘤分期病人两两检验P值表

Ⅰ	Ⅱ	Ⅲ	Ⅳ	?
Ⅰ	－	－	－	－
Ⅱ	－	－	0.8535	0.2365
Ⅲ	－	0.8535	－	0.1086
Ⅳ	－	0.2365	0.1086	－

图4 SCLC患者中各亚组CXCL-13的表达

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Role and clinical significance of Tfh cell associated factor CXCL-13 in the pathogenesis of small cell lung cancer

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Role and clinical significance of Tfh cell associated factor CXCL-13 in the pathogenesis of small cell lung cancer