ABSTRACT
Objective To study the characteristics of T regulatory cells (Treg) in primary biliary cirrhosis (PBC), and to analyze the significance of Treg in PBC. Methods Peripheral blood Treg cells of 27 PBC patients and 14 healthy controls were detected by tricolour flowcytometry. Simultaneously the expression of forkhead box p3 (Foxp3) mRNA was determined by real-time RT-PCR assay. The expression of Foxp3 positive T cells in liver was exmined by immunohistochemistry. Results The percentage of Treg in the peripheral blood was lower in PBC (P<0.01) than in healthy control group. The mRNA expression of Foxp3 had no significant difference (P>0.05) between the two groups. The infiltration of Foxp3 positive T cells in liver tissue was different in different pathological stages and different degree of inflammation of the portal area. Conclusion The possible reason for Treg decreasing in the peripheral blood of PBC and Treg increasing in local inflammatory portal area of liver is the result of local inflammation which then lead to migration of peripheral Treg in autoimmunity.
ABSTRACT
Objective To study the pattern of lymphatic metastasis in patients with thoracic esopha-geal carcinoma, and to determine the indication and the target volume for post-operative radiotherapy. Meth-ods 229 patients with thoracic esophageal carcinoma who had undergone radical esophagectomy and two-field lymph node dissection were included in this study. The pattern and ratio of lymph node metastasis were analyzed. The effect of the tumor length and pathology stage on lymph node metastasis was studied. Then the indication and target of post-operative radiotherapy for the thoracic esophageal carcinoma was determined. Results Regional lymph node metastasis was found in 57.1% patients with upper thoracic esophageal car-cinoma. For the middle thoracic esophageal carcinoma, the ratio of regional metastasis, skip, upward, down-ward and two-way spread were 39.0%, 19.5% ,5.2% ,28.6% and 7.8% ,respectively. For lower thoracic esophageal carcinoma,downward spread was found in 77.2% patients. For upper thoracie esophageal carci-noma,the proportions of patients with lymph node metastasis were 19.0% ,6.7% ,9.8% and 14.3% in the superior mediastinum, middle mediastinum, inferior mediastinum and abdominal cavity ( x2 = 2.75, P = 0.433). The corresponding figures were 26.1% ,7.4% ,11.8% and 11.9% (x2 = 17.98,P =0.000) for middle thoracic esophageal carcinoma,and 0%, 1.6% ,5.3% and 10.0% (x2= 5.96 ,P = 0. 051 ) for low-er thoracic esophageal carcinoma. The lymph node metastasis ratios were 9.1%, 11.6% and 11.7% in pa-tients with tumor ≤3 cm,3-5 cm and ≥5 cm,respectively (x2 =3.93,P=0. 140), and were much higher in stage Ⅲ disease than those in stage 0 to Ⅱ (19.3% vs4.8% ;x2 =131.06,P=0.000). Conclusions he pattern of lymph node metastasis is complex and extensive in patients with thoracic esophageal carcinoma. For upper and middle thoracic esophageal carcinoma, the extended prophylactic portal is suggested and the superior mediastinum is an important target area. For the lower thoracic esophageal carcinoma,it seems that regional fields could be applied. Post-operative radiotherapy should be performed in stage Ⅲ disease because of the high lymph node metastasis ratio.