- 學位論文
探討淋巴細胞次群分佈及活化在台灣健康男女性、口腔癌前病變病人及口腔癌病人之差異以及相關影響因子之研究
Analysis of different lymphocyte subsets and activation on healthy people, patient with precancerous lesion and oral cancer in Taiwan
摘要
本文利用流式細胞儀檢測台灣地區健康男女性（男80位、女50人）、口腔癌前病變病患（28位）及口腔癌病人（87位）的淋巴細胞次群（CD4/CD3-T細胞、CD8/CD3-T細胞、CD19-B細胞、CD56-NK細胞）及淋巴細胞活化（CD69、CD25）分佈。抽取受檢者周邊血液2 ml，經過檢測之後有三個主要的發現，一、淋巴細胞次群和活化的分佈會受到性別、年齡、種族不同而分佈有所差異。女性在CD4/CD3-T細胞比例比男性來得多。年齡大於60歲的男性，其CD8/CD3-T細胞、CD56-NK細胞比例比其他年齡層的男性來得高。而年齡小於30歲的男性在淋巴細胞CD8/CD69、CD8/CD25活化比例明顯高於其他年齡層的男性。二、淋巴細胞次群和活化的分佈是隨著疾病的進展不同而改變，結果發現，男性癌症病人的NK細胞、CD4/CD69、CD19/CD69和CD56/69淋巴活性比男性健康人來的高，B細胞和CD19/CD25淋巴活性比例比健康者來得低。口腔癌前病變的男性病人的NK細胞、CD4/CD3-T細胞及B細胞比例則比男性健康者來得高，另外口腔癌男性病人的B細胞則比口腔癌前男性病人來得低，但在淋巴細胞活化CD4/CD69的比例則是比較高。在女性癌症病人方面，結果類似男性病患，其NK細胞和CD4/CD69淋巴細胞活化比例皆高於健康女性。三、收集癌症男性病患臨床資料加以分析，包括腫瘤部位、臨床TNM stage、病理組織分類、病患嚼食檳榔、抽菸、喝酒習慣、系統性疾病及是否為首次得到等因素加以討論。我們發現影響口腔癌患者免疫細胞分佈不同的主因，乃為有無遠處轉移及是否為首次得到或是復發性癌症等原因，由統計結果發現，復發性病人的淋巴細胞CD56/CD69活化比例明顯比首次得到來得高，而到了重度癌症末期，癌症病人體內的免疫細胞分佈上明顯的改變，體內的CD4/CD3-T細胞比例明顯減少、CD8/CD3-T細胞比例增加，幾乎所有的淋巴細胞活活化比例皆增加。簡單來說，由資料結果顯示免疫系統會因為疾病的發展，而有所改變。最後我們依據上述的統計資料，寫出口腔癌、頸部淋巴轉移及是否為復發性癌症的預測方程式。
並列摘要
The lymphocyte subsets (CD4/CD3-T cell, CD8/CD3-T cell, CD19-B cell, CD56-NK cell) and lymphocyte activation antigen ( CD69, CD25) in the peripheral blood (2 ml) of healthy men and women in Taiwan (male: 80, female:50), per cancerous people (28 patients) and oral cancer people ( male: 87, female : 10) were analyzed using two-color flow cytometry. The data were analysised and the three main results were found. First, the sex, age, race can influence the distribution of lymphocyte subsets and activation. The distribution of CD4/CD3-T cell in women was higher than men. If men were older than 60 years of age, the increased proportion of CD8/CD3-T cell and NK cell were than others. If men were younger than 30 years of age, the increased proportion of activation CD8/CD69 and CD8/CD25. Second, the distribution of lymphocyte subsets and activation were change with process of disease. The results showed that the distribution of NK cell, CD4/CD69, CD19/CD69 and CD56/CD69 in men with oral cancer were increased siginificantly in healthy men, and decreased expression of B cell and CD19/CD25 was noted compared with B cell and CD19/CD25 in healthy men. The increased expression NK cell and B cell in men with precancerous lesion was than healthly men. The distribution of NK cell in women with oral cancer was increased than healthy women. Third, we collect all data of patients including diagnosis, TMN stage, pathologic report, fresh or recurrent cancer, systemic disease, habit of chewing betel quids, smoking and drinking. These data were analysised, and we found that habit, pathologic status, tumor location, tumor size and systemic disease were not the major influenced factor. We found that organ metastasis and recurrent were the major influenced factor. The expression of activation in CD56/CD69 in men with recurrent oral cancer was increased than men with fresh cancer. The lymphocyte subsets and activation expression of advanced-terminal oral cancer patient were siginificantly change. Final, we make the prediction program for oral cancer according to data.