Introduction There has been increasing evidence that the gut microbiota is closely related to type 2 diabetes (T2D). Metformin (Met) is often used in combination with saxagliptin (Sax) and repaglinide (Rep) for the treatment of T2D. However, little is known about the effects of these combination agents on gut microbiota in T2D.Research design and methods A T2D mouse model induced by a high-fat diet (HFD) and streptozotocin (STZ) was employed. The T2D mice were randomly divided into six groups, including sham, Met, Sax, Rep, Met+Sax and Met+Rep, for 4 weeks. Fasting blood glucose level, serum biochemical index, H&E staining of liver, Oil red O staining of liver and microbiota analysis by 16s sequencing were used to access the microbiota in the fecal samples.Results These antidiabetics effectively prevented the development of HFD/STZ-induced high blood glucose, and the combination treatment had a better effect in inhibiting lipid accumulation. All these dosing regimens restored the decreasing ratio of the phylum Bacteroidetes: Firmicutes, and increasing abundance of phylum Desulfobacterota, expect for Met. At the genus level, the antidiabetics restored the decreasing abundance of Muribaculaceae in T2D mice, but when Met was combined with Rep or Sax, the abundance of Muribaculaceae was decreased. The combined treatment could restore the reduced abundance of Prevotellaceae_UCG-001, while Met monotherapy had no such effect. In addition, the reduced Lachnospiraceae_NK4A136_group was well restored in the combination treatment groups, and the effect was much greater than that in the corresponding monotherapy group. Therefore, these dosing regimens exerted different effects on the composition of gut microbiota, which might be associated with the effect on T2D.Conclusions Supplementation with specific probiotics may further improve the hypoglycemic effects of antidiabetics and be helpful for the development of new therapeutic drugs for T2D.

The loach (Misgurnus anguillicaudatus), a small commercial fish that is widely cultivated for its high-quality protein, vitamins, minerals, and essential amino acid, is a member of the genus Misgurnus and the family Cyprinidae. In this study, we gave the LPS-injected loach fermented soybean meal and used transcriptome sequencing to investigate the impact of the fermented soybean powder on the loach's immune system. 3384 up-regulated genes and 12116 down-regulated genes were found among the 15500 differentially expressed genes, according to the results. The differentially expressed genes were shown to be involved in cellular processes, metabolic processes, cellular anatomical entities, and binding, according to the Go functional annotation. Meanwhile, the KEGG enrichment analysis indicated that the soybean fermented powder treated groups showed significant differences in DNA replication, Nucleotide excision repair, Fanconi anemia pathway, and Base excision repair pathways, suggesting that these pathways are closely related to the enhancement of the immune function of loach by soybean fermented powder. The particular conclusions not exclusively can provide a new conception for the rational utilization of soybean fermented powder but also can provide theoretical guidance for the subsequent healthy breeding of loach.

Supplemental Figure 1. Th17 cells are not induced in the lung after the tumor cell challenge. Supplemental Figure 2. No significant difference in the production of IFN-gamma by NK cells in the Abt mice compared with the control.

目的 探讨血清颗粒蛋白前体(PGRN)在Ⅰ型自身免疫性肝炎(AIH)预后评估中的价值.方法 选取活动期Ⅰ型AIH患者39例(AIH组)、健康体检者35名(正常对照组).收集所有研究对象的一般资料和实验室指标[白细胞(WBC)计数、血清肝脏酶类、免疫球蛋白和自身抗体]检测结果,并检测血清PGRN、白细胞介素(IL)-17和IL-10水平.分析Ⅰ型AIH患者治疗前、后各项指标的差异和复发患者血清PGRN的变化.采用Spearman相关分析评估各项指标之间的相关性.采用受试者工作特征(ROC)曲线评价血清PGRN判断Ⅰ型AIH患者复发的效能.结果 AIH组血清PGRN、IL-17水平显著高于正常对照组(P<0.05),血清IL-10水平显著低于正常对照组(P<0.05).Ⅰ型AIH患者PGRN与IL-17、γ-谷氨酰基转移酶(GGT)、IgG和IgM均呈正相关性(r值分别为0.410、0.489、0.596、0.525,P<0.05).Ⅰ型AIH患者治疗后血清PGRN水平均显著低于治疗前(P<0.01).复发组血清PGRN水平显著高于未复发组(P<0.05).ROC曲线分析结果显示,血清PGRN判断Ⅰ型AIH患者复发的曲线下面积(AUC)为0.78,以80.75 pg/mL为最佳临界值,敏感性为62.50％,特异性为83.33％.结论 Ⅰ型AIH患者血清PGRN水平升高,且与AIH的疗效和复发有关,或可作为评价肝脏炎症损伤程度和疾病复发的指标之一.

Supplemental materials and methods

Background Colorectal cancer (CRC) is one of the most common malignancies and the patient survival rate remains unacceptably low. The anti-programmed cell death-1 (PD-1)/programmed cell death ligand 1 (PD-L1) antibody-based immune checkpoint inhibitors have been added to CRC treatment regimens, however, only a fraction of patients benefits. As an important co-stimulatory molecule, 4-1BB/CD137 is mainly expressed on the surface of immune cells including T and natural killer (NK) cells. Several agonistic molecules targeting 4-1BB have been clinically unsuccessful due to systemic toxicity or weak antitumor effects. We generated a humanized anti-4-1BB IgG4 antibody, HuB6, directed against a unique epitope and hypothesized that it would promote antitumor immunity with high safety. Methods The antigen binding specificity, affinity and activity of HuB6 were determined by enzyme-linked immunosorbent assay (ELISA), surface plasmon resonance (SPR), biolayer interferometry (BLI) and flow cytometry. The antitumor effects were evaluated in humanized mice bearing syngeneic tumors, and possible toxicity was evaluated in humanized mice and cynomolgus monkeys. Results HuB6 showed high specificity and affinity for a binding epitope distinct from those of other known 4-1BB agonists, including utomilumab and urelumab, and induced CD8 + T, CD4 + T and NK cell stimulation dependent on Fcγ receptor (FcγR) crosslinking. HuB6 inhibited CRC tumor growth in a dose-dependent manner, and the antitumor effect was similar with urelumab and utomilumab in humanized mouse models of syngeneic CRC. Furthermore, HuB6 combined with an anti-PD-L1 antibody significantly inhibited CRC growth in vivo. Additionally, HuB6 induced antitumor immune memory in tumor model mice rechallenged with 4 × 10 6 tumor cells. Toxicology data for humanized 4-1BB mice and cynomolgus monkeys showed that HuB6 could be tolerated up to a 180 mg/kg dose without systemic toxicity. Conclusions This study demonstrated that HuB6 should be a suitable candidate for further clinical development and a potential agent for CRC immunotherapy.

目的 探讨N6-甲基腺嘌呤(m6 A)去甲基酶肥胖相关蛋白(FTO)在乳腺癌细胞对曲妥珠单抗耐药中的作用及新型抗人表皮生长因子受体2(HER2)人源化A21抗体(HuA21)对耐药性乳腺癌细胞增殖的影响.方法 制备曲妥珠单抗耐药细胞株(BT474/TR),光学显微镜观察BT474/TR与BT474细胞形态,四甲基偶氮唑盐(MTT)法检测细胞增殖,免疫荧光法检测增殖相关抗原(Ki67)表达,流式细胞术检测细胞周期,qPCR和Western blot法检测FTO与甲基转移酶样蛋白3抗体(METTL3)表达.结果 BT474/TR出现细胞核固缩、伪足消失,细胞增殖速度下降.曲妥珠单抗处理BT474不同时间至形成耐药细胞,Ki67表达逐渐降低(P<0.05),S期细胞比例逐渐减小(P<0.05),FTO表达逐渐增加(P<0.05),但是METTL3表达没有变化.FTO抑制剂甲氯芬那酸乙酯(MA2)促进BT474/TR细胞增殖,且提高其对曲妥珠单抗的敏感性(P<0.05).HuA21抗体对BT474/TR细胞增殖具有抑制作用(P<0.05),且联合MA2和曲妥珠单抗对BT474/TR细胞抑制效果更好(P<0.05).结论 HER2阳性乳腺癌细胞FTO基因表达与其对曲妥珠单抗耐药之间存在相关性,抑制FTO活性可以增强乳腺癌耐药细胞对曲妥珠单抗治疗的敏感性;HuA21抗体对曲妥珠单抗耐药性乳腺癌细胞有抑制作用.

Background: Although epidemiologic studies have suggested that thyroid disease may be a risk factor for age-related macular degeneration (AMD), this finding is still controversial. Objectives: The aim of this meta-analysis was to investigate whether an association exists between thyroid disease and medication and AMD in epidemiologic studies. Methods: We searched PubMed, EMBASE, and Google Scholar from their inception to March 2020 for cross-sectional, case-control, and cohort studies that assessed thyroid function and AMD risk. Data from selected studies were extracted, and a meta-analysis was performed using fixed-effects or random-effects models. The statistical heterogeneity (I2) among studies and the possibility of publication bias were evaluated. If I2 >50%, a significant heterogeneity existed among studies, and a random-effects model was used to calculate the pooled RR. Otherwise, a fixed-effects model was performed. Results: A total of 13 epidemiologic studies that consisted of 7 thyroid disease and 7 thyroid medication studies were included. Statistically significant heterogeneity was observed in the study results (I2thyroid disease = 80.1%; I2thyroid medication = 69.0%). A significant positive association was found between thyroid disease and AMD, with an overall relative risk (RR) of 1.25 (95% CI: 1.02, 1.54). However, there was no statistical association between thyroid medication and AMD risk (pooled RR 1.26 [95% CI: 0.92–1.72]). Egger’s test indicated that there was no significant publication bias for thyroid disease (p = 0.889) or thyroid medication (p = 0.226). Conclusions: Our findings indicate that thyroid disease is associated with higher AMD risk. Thyroid disease prevention strategies may have a significant effect on the prevention of AMD and warrant further evaluation.

目的 通过对冠心病和脑卒中患者的CYP2C19基因多态性进行分析,为临床血小板聚集抑制剂的个体化应用,推进精准药物治疗提供依据.方法 采用实时荧光定量RT-PCR对4270例冠心病患者和141例脑卒中患者的基因型和代谢型进行分析.统计每种基因型和代谢型的分布情况,并探讨不同性别、不同年龄以及不同病种之间的基因型和代谢型是否具有统计学差异.结果 冠心病患者中,男性、女性人群基因型分布前3位分别为*1/*1、*1/*2、*2/*2型,以及*1/*2、*1/*1、*2/*2型,中青年与老年人群的基因型分布前3位均分别为*1/*1、*1/*2、*2/*2型;不同性别、不同年龄人群代谢型均为中代谢型最多.脑卒中患者中,男性、女性人群基因型分布前3位分别为*1/*1、*1/*2、*1/*3型,以及*1/*1、*1/*2、*2/*2型,中青年与老年人群的基因型分布前3位均分别为*1/*1、*1/*2、*2/*2;不同性别、不同年龄人群代谢型均为快代谢型最多.不同病种之间的基因型分布前3位均分别为*1/*1、*1/*2、*2/*2型,冠心病人群代谢型为中代谢型最多,脑卒中人群代谢型为快代谢型最多.以上年龄组、性别组之间均无统计学差异(P>0.05).结论 冠心病和脑卒中患者存在基因多态性,建议临床使用氯吡格雷等血小板聚集抑制剂之前进行CYP2C19基因型检测,避免出现氯吡格雷抵抗.

Background: beta-Arrestins have been found to regulate cell proliferation, invasion and migration; transmit antiapoptotic survival signals; and affect other characteristics of tumours. However, their role in gastric cancer (GC) is not clear. We investigated the role and mechanism of beta-arrestins in the regulation of GC. Methods: We first examined beta-arrestins mRNA levels in 17 pairs of GC tissues by qRT-PCR. We also used immunohistochemistry to further examine the expression of beta-arrestins in 60 paraffin-embedded primary GC tissues and 20 normal gastric tissues. Then, the function of beta-arrestin1 was investigated in vitro and in vivo. Results:beta-Arrestin1 was upregulated in GC tissue and was associated with tumour stage, lymph node metastasis, invasion depth and patient sex. High expression of beta-arrestin1 expression predicted poor prognosis in GC. beta-Arrestin1 promoted GC cell proliferation, migration and invasion, and it suppressed E-cadherin expression and upregulated Vimentin expression via AKT/ERK signalling pathway. The in vivo metastasis assays showed that knockdown of beta-arrestin1 reduced lung metastasis and inhibited EMT. Conclusion: The upregulation of beta-arrestin1 predicts poor prognosis and promotes metastasis and epithelial-mesenchymal transition in GC through AKT/ERK signalling pathway. This study may provide therapeutic advances for the treatment and early diagnosis of patients with metastatic GC.

目的 挖掘分析G蛋白偶联受体35(GPR35)基因在胃癌中的表达及意义.方法 采用cBioportal分析工具对TCGA数据库中GPR35在胃癌组织的基因改变频率进行分析;运用Oncomine数据库分析胃癌组织与正常胃黏膜中GPR35 mRNA表达的差异性;应用SPSS软件分析GPR35在胃癌组织中的表达水平与患者临床病理参数之间的关系;运用Kaplan-Meier Plotter数据库探讨GPR35 mRNA表达水平与胃癌患者预后的关系.结果 在TCGA数据库中GPR35基因改变形式主要表现为缺失.除了Oncomine数据库DErrico数据集中GPR35 mRNA在混合型胃癌中的表达较正常胃黏膜降低(P =0.501),在不同分型(肠型、弥漫型和混合型)胃癌中GPR35 mRNA的表达均高于正常胃黏膜(P＜0.05).GPR35的表达与肿瘤的分化程度、TNM分期、淋巴结转移和远处转移以及HER2表达与否显著相关,而与患者性别、肿瘤浸润深度、Lauren分型和治疗策略均无显著相关性.通过Kaplan-Meier Plotter数据库分析发现,GPR35 mRNA高表达的胃癌患者总生存期[HR=1.62(1.36～1.93),P=3.6×10-8],首次进展[HR=1.52(1.24～1.86),p=4.2×10-5]及进展后生存期[HR =2.53(2.02～3.16),P＜1 ×10-16]均缩短,患者预后差.结论 GPR35 mRNA在胃癌中的表达是上调的,其表达水平与胃癌患者的生存期显著相关,提示GPR35可能作为判断胃癌患者预后的潜在生物学指标以及分子靶向治疗的靶点.

目的 探讨胃癌细胞中受TCF7L2表达调控的WNT7b及它们对胃癌细胞增殖与转移的影响.方法 qPCR与PCR芯片技术检测临床标本与胃癌细胞株中TCF7L2与WNT7b等基因的表达情况;使用200 ng/ml重组人WNT7b蛋白处理SGC7901与N87等胃癌细胞株,qPCR与Western blot法检测TCF7L2的表达,双荧光素酶报告基因检测系统检测β-catenin/TCF结合活性;为分析WNT7b对TCF7L2mRNA稳定性的影响采用2μg/ml放线菌素D处理N87细胞.采用CCK-8试剂盒检测胃癌细胞的增殖能力,细胞划痕与Transwell实验分析胃癌细胞的迁移能力.结果 分析SGC7901/TCF7L2、N87/shTCF7L2及其对照细胞株的PCR芯片数据,发现受TCF7L2表达影响最大的WNT配体是WNT7b.通过17例胃癌标本检测发现胃癌组织TCF7L2与WNT7b的转录水平均高于配对的癌旁正常组织,且二者表达呈正相关关系.使用WNT7b处理N87细胞24 h即可发现细胞TCF7L2转录水平升高(P ＜0.001),WNT7b同时增强了TCF7L2的mRNA稳定性(P＜0.05),TCF7L2的蛋白水平以及β-catenin/TCF结合活性也随之增高(P＜0.05).通过细胞学实验显示WNT7b与TCF7L2能够增强胃癌细胞的增殖与迁移能力(P＜0.05).结论 胃癌组织中TCF7L2与WNT7b表达水平高于正常对照组织;WNT7b与TCF7L2之间存在相互促进表达的作用,共同发挥对胃癌细胞增殖与迁移能力的调控.

Epithelial ovarian cancer (EOC) is one of the most common and lethal gynecological cancers. Novel therapeutic agents have been developed for EOC, but patient survival remains poor. Trastuzumab has been approved for breast and gastric cancers with high expression of human epidermal growth factor receptor 2 (HER2), but it has not achieved any clinical success in EOC. Dysregulated Wnt/β-catenin signaling is involved in cancer development, but whether it plays a role in EOC resistance to trastuzumab remains largely unknown. Here, we observed that high expression of Wnt3a, β-catenin and TCF7L2, which can form a signaling axis in the Wnt/β-catenin pathway, commonly existed in HER2-positive EOC tissue samples and was correlated with a poor patient prognosis. Cell proliferation and migration assays and nude mouse xenograft model experiments demonstrated that the Wnt3a/β-catenin/TCF7L2 signaling axis promoted tumor cell growth and metastasis and reduced tumor sensitivity to trastuzumab. Analysis of downstream Akt signaling suggested that the function of the Wnt3a/β-catenin/TCF7L2 signaling axis was mediated, at least in part, through increasing Akt phosphorylation. Overall, this study reveals a crucial role for the Wnt3a/β-catenin/TCF7L2 signaling axis in EOC resistance to trastuzumab and the potential application of HER2-targeted drugs combined with inhibitors of this signaling axis for EOC treatment.

Cancer is an age-associated disease, potentially related to the altered immune system of elderly individuals. However, cancer has gradually decreased incidence in the eldest globally such as the most common lung cancer, the mechanisms of which remain to be elucidated. In this study, it was found that the number of lung-resident γδT cells was significantly increased with altered gene expression in aged mice (20-24 months) versus young mice (10-16 weeks). Aged lung Vγ4+ and Vγ6+ γδT cells predominantly produced interleukin-17A (IL-17A), resulting in increased levels in the serum and lungs. Moreover, the aged mice exhibited smaller tumors and reduced numbers of tumor foci in the lungs after challenge with intravenous injection of B16/F10 melanoma cells compared with the young mice. Aged lung Vγ4+ and Vγ6+ γδT cells were highly cytotoxic to B16/F10 melanoma cells with higher expression levels of CD103. The markedly longer survival of the challenged aged mice was dependent on γδT17 cells, since neutralization of IL-17A or depletion of indicated γδT cells significantly shortened the survival time. Consistently, supplementation of IL-17A significantly enhanced the survival time of young mice with lung melanoma. Furthermore, the anti-tumor activity of aged lung γδT17 cells was not affected by alterations in the load and composition of commensal microbiota, as demonstrated through co-housing of the aged and young mice. Intrinsically altered lung γδT17 cells underlying age-dependent changes control lung melanoma, which will help to better understand the lung cancer progression in the elderly and the potential use of γδT17 cells in anti-tumor immunotherapy.

恶性肿瘤与机体衰老有关,在老年人群中高发,是老年人的常见病,也是主要的死亡原因. 由于老年人常多病共存,恶性肿瘤的症状有时不明显,在治疗过程中,多病体质又影响病人对药物治疗的耐受性[1]. 因此,对于老年肿瘤病人,需要评估病人的功能状态,以指导病人选择合理的化疗方案. 老年综合评估( com-prehensive geriatric assessment,CGA)已在国际上被广泛认可,应用综合评估可以反映病人自身的功能状态.有研究学者认为,可以根据病人机体的功能状态分析病人对药物的耐受能力,选择适合的药物,提前预测化疗后的不良反应,并积极做好预防[2]. 本文就CGA在老年肿瘤病人中的应用报道如下.

目的 探讨共生菌群对小鼠外周血及黏膜相关组织(肺脏、肝脏)中趋化因子配体24(CCL24)及胰岛素样生长因子1(IGF-1)表达的调控作用.方法 利用ELISA方法检测共生菌缺失小鼠(Abx鼠)及正常小鼠(WT鼠)血清中、肺脏及肝脏组织匀浆中CCL24及IGF-1的浓度,并对其表达量进行分析比较.结果 小鼠缺失共生菌后,其血清中CCL24浓度上调[WT与Abx,(1.018±0.043)μg/L与(1.509±0.119)μg/L],而IGF-1浓度无显著变化[WT与Abx,(1.240±0.019)μg/L与(1.250±0.066)μg/L];其肺脏中CCL24[WT与Abx,(11.984±0.683)ng/g与(14.626±0.769)ng/g]和IGF-1[WT与Abx,(0.998±0.024)ng/g与(1.290±0.031)ng/g]表达量均显著上调;其肝脏中CCL24(WT与Abx,(11.575±0.609)ng/g与(8.704±0.458)ng/g]和IGF-1[WT与Abx,(2.989±0.073)ng/g与(1.112±0.027)ng/g]表达量均显著下调.结论 共生菌对小鼠外周血、肺脏、肝脏中CCL24和IGF-1表达调控具有组织特异性.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:通过了解农村老年人慢病的状况,分析其构成特点及探讨他们对医疗服务实际需求的现状,客观分析其影响因素,为建立有效的农村老年慢病管理模式及合理配置医疗服务资源提供指导方向。方法:根据老年人常见慢病需求指导设计调查问卷,问卷内容包括:一般情况、常见慢病调查、医疗服务需求三个部分。选取15个典型的农村,选择900名老年人进行问卷调查。结果:农村老年人群中所患慢病主要是高血压、关节病（腰腿痛）、脑梗死、冠心病,慢性胃炎;老年人希望得到的医疗服务主要有:老年人常见疾病保健知识宣传、老年人科学饮食营养指导、老年人常用药物用药指导、老年人功能锻炼指导、老年人家庭急救知识技能培训、县级以上医院下派固定医生定期上门健康服务。结论:农村老年人对医疗保健服务的需求明显提高,应建立有效的农村医养结合服务体系、慢病防控体系,加强对老年慢病营养保健、合理用药、功能锻炼的系统指导。</span>

In recent years, there have been incidents involving the illegal addition of phthalic acid esters (PAEs) to liquors. It is well known that PAEs such as butyl benzyl phthalate (BBP) have estrogen-like effects, so high PAE levels in the body can lead to a decreased sperm count in males and altered sexual organ development in children, for example. The rapid detection of PAEs in liquor is therefore an important task. Compared with traditional methods of testing for PAEs, surface-enhanced Raman spectroscopy (SERS) offers higher sensitivity and the ability to search for chemical fingerprints, allowing the rapid detection of particular PAEs. In the present work, we synthesized Ag@Fe3O4@Ag/β-cyclodextrin (CD) nanoparticles for use as a SERS-active substrate. Fe3O4 aggregates quickly under the influence of an external magnetic field, making it possible to magnetically separate out the NPs, which simplifies sample processing. The detection limit of the system for PAEs is also improved because the β-CD acts as a functional group with a cavity structure that is capable of adsorbing BBP to form a host (β-CD)–guest (BBP) complex. This substrate was shown to possess good repeatability and sensitivity when using malachite green (MG) as a probe molecule. Furthermore, the nanoparticle-based SERS substrate permitted the detection of BBP down to a level of 1.3 mg/kg in liquor, which is low enough to be able to detect BBP in real-world liquor samples. We expect that this method will prove useful for the rapid detection of PAEs in food.

目的 探讨公立医院老年医学科参与中国养老服务体系运行模式的构建,分析老年慢性病患者延续性服务模式的临床价值及社会价值,以进一步评价老年医学科专科医疗延伸服务的重要性.方法 选择安徽省立医院老年医学科住院患者200例,随机分为两组,其中观察组100例患者参与住院-居家延续性医疗服务模式(出院时,开展老年综合评估,出院后对各种慢病指导合理用药,并对慢病并发症进行三级预防,对半失能、失能老人进行居家环境评估、功能锻炼指导、家庭护理指导、营养及精神心理指导),另对照组100例患者住院-出院,出院时开展老年综合评估,但未参加延续性医疗服务模式,比较两组患者1年内再次住院的次数、人均年卫生支出费用及患者生活能力(Barthel指数评定表)、家庭及患者对患者自身状况满意度比较.结果 观察组再次住院次数与人均年卫生支出费用明显低于对照组,观察组Barthel指数评分及患者自身状况满意度显著高于对照组.结论 老年医学科参与的老年慢性病患者延续性服务模式能够有效地提高老年患者的生活质量.

目的 通过比较不同分期上消化道肿瘤患者外周血NK细胞、调节性T细胞、T淋巴细胞(CD4+T细胞及CD8+T细胞)比例的变化情况,探讨其在上消化道肿瘤病情评估中的价值.方法 将102例上消化道肿瘤患者按肿瘤分期分为2组:对照组45例,均为Ⅱ—Ⅲ期患者,观察组57例,均为Ⅳ期患者,比较2组外周血中NK细胞、调节性T细胞、CD4+T细胞、CD8+T细胞的比例.结果 与对照组相比,观察组外周血调节性T细胞比例差异无统计学意义(P>0.05),CD4+T细胞比例明显降低、CD8+T细胞和NK细胞比例均明显增高,差异有统计学意义(均P<0.05).结论 不同临床分期的上消化道肿瘤患者外周血免疫功能存在差异,外周血NK细胞、T淋巴细胞、调节性T细胞联合检测对上消化道肿瘤患者的病情判断及预后评估具有重要的参考价值.