中文摘要：

目的 观察鼻咽癌患者外周血T淋巴细胞及癌组织IL-21蛋白的表达变化，并探讨其意义。方法 采用流式细胞术检测29例鼻咽癌放疗前患者（ A组）、34例鼻咽癌放疗后患者（ B组）、7例血浆EBV-VCA-IgA阳性鼻咽癌高危者（ C组，非鼻咽癌患者）和28例血浆EBV-VCA-IgA阴性的健康体检者（对照组）外周血CD3^＋、CD4^＋、CD8^＋、CD2^＋5 T细胞亚群；采用免疫组化法检测52例鼻咽癌、15例鼻咽黏膜慢性炎症组织中的IL-21蛋白，分析IL-21蛋白表达与鼻咽癌临床病理参数的关系。结果 A组CD3^＋、CD4^＋细胞百分比及CD4^＋/CD8^＋值低于另三组，CD8＋细胞百分比高于另三组（P均＜0．05）；A、B组CD2＋5细胞百分比均高于C组及对照组（P均＜0．05）；鼻咽癌组织中IL-21阳性表达率高于鼻咽黏膜慢性炎症组织（P＜0．05）；Ⅰ＋Ⅱ期鼻咽癌患者肿瘤组织中IL-21阳性表达率高于Ⅲ＋Ⅳ期者，高分化腺癌中IL-21表达阳性率高于低分化腺癌者（ P均＜0．05）。结论 鼻咽癌患者癌组织中IL-21蛋白表达上调，外周血CD8＋细胞百分比提高，二者均与鼻咽癌的发病有关。

英文摘要：

Objective To investigate the clinical significance of changes in levels of IL-21 protein and peripheral blood T lymphocyte in carcinoma tissues of patients with nasopharyngeal carcinoma （ NPC） and to initially dicuss the rela-tionship between latent infection of EBV and cellular immunity of nasopharyngeal microenvironment and peripheral blood . Methods The peripheral blood CD 3^＋, CD4^＋, CD8^＋, CD2^＋5 T lymphocyte subsets were detected by flow cytometry in 29 cases of NPC patients without radiotherapy （ group A ） , 34 cases of NPC patients with radiotherapy （ group B ） , 7 cases of EBV-VCA-IgA positive people （ group C） and 28 cases of EBV-VCA-IgA negative people （ control group ） .Immunohisto-chemistry was adopted to detect IL-21 protein expression in 52 cases of NPC tissues and 15 cases of chronic nasopharyngitis tissues and the relationship between IL-21 protein expression and the clinicopathological parameters was analyzed .Results The percentages of peripheral blood CD 3^＋, CD4^＋T lymphocytes, the ratio of CD4^＋/CD8^＋, and the percentage of CD8＋in the group A were higher than the other three groups （all P〈0.05）.The percentage of CD2^＋5 T lymphocytes in the group A and B was higher than that of the group C and the control group （all P〈0.05）.The positive expression rate of IL-21 in the NPC tissues was higer than that of chronic rhinitis mucosa （P〈0.05）.The positive expression rate of IL-21 in the I ＋II stage NPC tissues of patients was higher than that in stage III ＋IV, and the positive expression rate of IL-21 of high-differ-entiated adenocarcinoma was also higher than that of low-differentiated adenocarcinoma （all P〈0.05）.Conclusion The expression of IL-21 protein in the NPC tissues of NPC patients is up-regulated , and peripheral blood T cell percentage increases, both of which are associated with the pathogenesis of nasopharyngeal carcinoma .