摘要目的 探讨外周血CD+8 NKT细胞活化受体NKG2D及其分泌性配体sMICA检测在食管癌、贲门癌诊断及术后疗效评价中的临床意义.方法 对53例患者确诊后(29例手术患者术前14 d及术后14 d)及30名健康对照组采用流式细胞术对外周血CD+8NKT细胞中活化受体NKG2D阳性细胞百分比测定,应用酶联免疫吸附法进行sMICA含量测定,并各自进行差异性分析,同时对两者进行依从性分析.结果 患者外周血CD+8NKT细胞中NKG2D阳性细胞百分比为(77.632±8.972)%,明显低于对照组的(89.053±6.515)%(t=-6.113,P＜0.05);TNM分期Ⅱ、Ⅲ、Ⅳ期患者依次降低(F=99.251,P＜0.01);有区域淋巴结转移者均低于无区域淋巴结转移者(沁-10.384,P＜0.01);鳞状细胞癌高于腺癌(t=9.899,P＜0.01);术前均低于术后(t=-4.319,P＜0.01).患者血清sMICA的含量为(326.28±85.407)pg/ml,明显高于对照组的(210.00±22.560)pg/ml(t=7.292,P＜0.01);Ⅱ、Ⅲ、Ⅳ期患者依次增高(F=63.355,P＜0.01);有区域淋巴结转移者均高于无区域淋巴结转移者(t=7.770,P＜0.01);鳞状细胞癌低于腺癌(t=-7.593,P＜0.01);术前均高于术后(t=7.027,P＜0.01).血清sMICA对外周血CD+8NKT细胞活化受体NKG2D有抑制作用(F=142.773,P＜0.05),决定系数R2=0.7368.结论 外周血CD+8NKT细胞活化受体NKG2D及其分泌性配体sMICA含量的测定有助于食管癌、贲门癌分期的临床辅助诊断,对判断其生物学行为及预后有重要临床意义,并可作为患者手术治疗效果指标.

abstractsObjective To evaluate the clinical diagnostic application and operative efficacy of the expression of NKG2D in peripheral blood CD+8 NKT cell and its ligand sMICA in patients with esophageal or cardiac carcinoma.Methods The peripheral blood NKG2D positive CD+8 NKT cell percentage was concomitantly determined by flow cytometry in 53 preoperative patients including 29 postoperative patients with esophageal or cardiac carcinoma and 30 healthy controls.The serum sMICA was determined by ELISA.Results The peripheral blood NKG2D positive CD+8 NKT cell percentage in patients was significantly lower than that in controls [(77.632±8.972) % vs (89.053±6.515) %] (t = -6.113,P ＜0.05); with stage Ⅱ,Ⅲ,Ⅳ,it decreased significantly in order (F = 99.251,P ＜0.01);with lymph node metastasis lower than that without lymph node metastasis (t = -10.384,P ＜0.01); squamous carcinoma was higher than adenocarcinoma (t =9.899,P ＜0.01); postoperative was significantly higher than preoperative (t =-4.319,P ＜0.01).The level of serum sMICA in patients was significantly higher than that in controls [(326.28±85.407) pg/ml vs (210.00±92.560) pg/ml](t =7.292,P ＜0.01); with stage Ⅱ,Ⅲ,Ⅳ,it increased significautly in order (F =63.355,P ＜0.01); with lymph node metastasis higher than that without lymph node metastasis (t =7.770,P ＜0.01); squamous carcinoma was lower than adenocarcinoma (t =-7.593,P＜0.01); postoperative was significantly lower than preoperative (t =7.027,P ＜0.01).Serum sMICA could inhibit peripheral blood CD+8 NKT cell activation receptor NKG2D (F =142.773,P ＜0.05),determination coefficient R2 = 0.7368.Conclusion The level of peripheral blood CD+8NKT cell activation receptor NKG2D and serum sMICA in patients could be an assistant indicator for