Abstract:

Objective To analyze the diversify trend characteristics and implication of dendritic cells（DCs）and its subsets myeliod DC（mDC）and plasmacytoid DC（pDC）in peripheral blood of transitional cell carcinoma after kidney transplantation，and to confer the profile of DCs and subsets in de novo malignant tumor after kidney transplantation. Methods White blood cell（WBC）and mononuclear cell（PBMNC）in peripheral blood of 9 transitional cell carcinoma patients after kidney transplantation were measured before and 1 day after tumorectomy. DCs' quantity，subsets and mDC/pDC were detected using flow cytometry. 7 renal transplantation patients who had been survived over two years and 30 patients with transitional cell carcinoma of bladder were included in this research as long term control and common tumor control. 15 volunteers（control group）were studied as healthy controls. Results The levels of DCs of all the patients groups were lower than healthy people control group，the total mDC level of long term survival group was the lowest（P＜0.05）. Compared with long term survival group， there was no difference in DCs with two subset of tumor groups（all P＞0.05）. The pDC level of the transitional cellcarcinoma patients after kidney transplantation was decreased and the ratio of mDC/pDC was significantly higher than other groups（all P＞0.05）. Different from carcinoma after kidney transplantation，mDC in patient with transitional cell carcinoma of bladder were decreased significantly and pDC level decreased slightly. After tumorectomy，mDC and pDC levels in both groups were increased with different extent. Conclusions Changes in DCs and their subsets were different between the carcinoma patients after kidney transplantation and common transitional cell carcinoma of bladder. This difference suggested that disequilibrium of immune system of kidney transplant recipient should be response to carcinoma after kidney transplantation. Monitoring the level of DCs and subsets is helpful for the forecast of tumor immunity surveillance and cancer relapse.

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摘要：

目的 观察肾移植后新发泌尿系统移形细胞癌患者外周血中树突细胞（dendritic cells，DCs） 及其亚群髓样 DC（mDC）和浆细胞样 DC（pDC）的变化，探讨其在移植后肿瘤发生的表现。方法 收 集 9 例肾移植术后并发泌尿系统移形细胞癌病人，检测肿瘤切除术前、术后外周血中白细胞总数和单个 核细胞数（PBMNC）；应用流式细胞术测定 DCs 及其亚群的数量和 mDC/pDC。7 例肾移植后两年以上肾 功能稳定病人作为肾移植长期存活对照，30 例普通泌尿系统移形细胞癌病人作为肿瘤对照，15 例健康 志愿者作为正常对照。结果 3 组病人 DCs 总数均低于正常人群，长期存活病例 mDC 降低幅度最为显著 （P＜0.05）。两组肿瘤病例与肾移植长期存活病例比较，DCs 及亚群均无差异（均 P＞0.05）。移植后肿瘤 病人 pDC 明显降低，mDC 与 pDC 比值明显高于其他各组（均 P＞0.05）。与移植后肿瘤病人不同，普通肿 瘤病人 mDC 明显降低，pDC 降低不明显。肿瘤切除后，两组肿瘤病人的 mDC 和 pDC 均有不同程度增长。 结论 DC 及其亚群的变化在肾移植后肿瘤及普通肿瘤病人之间有所不同，其变化差异提示免疫状态失衡与 肾移植肿瘤的发生密切相关。通过监测外周血 DCs 及亚群的变化，可能有助于预测肾移植后肿瘤免疫监视 状态和肿瘤的复发。

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