Ćelije nalik supresorskim ćelijama mijeloidnog porekla – da li se njihov broj menja kod bolesnika u različitim stadijumima kolorektalnog karcinoma?
Sažetak
Uvod/Cilj. Kolorektalni karcinom (KRK) je jedan od najčešćih karcinoma u populaciji, koji često dovodi i do smrtnog ishoda. Supresorske ćelije mijeloidnog porekla (SĆMP) pripadaju heterogenoj grupi nezrelih ćelija, za koje se smatra da imaju imunosupresivni efekat, koji može da pomogne razvoju i širenju tumora. Cilj rada bio je da se analizira učestalost i značaj ćelija nalik SĆMP kod bolesnika u različitim stadijumima KRK. Metode. Analizirani su uzorci periferne krvi (PK) 83 bolesnika u različitim stadijumima bolesti i 12 zdravih ispitanika koji su činili kontrolnu grupu. U uzorcima PK su, na osnovu imunofenotipskih obeležja, identifikovane ćelije nalik SĆMP i određen je njihov broj. Rezultati. Utvrđen je statistički značajan porast apsolutnog i relativnog broja ćelija nalik polimorfonuklearnim (PMN) SĆMP (PMN-SĆMP) u PK svih bolesnika sa KRK, u odnosu na kontrolnu grupu (p < 0,0001). Kada nije vršeno poređenje prema stadijumima KRK, nije uočen statistički značajan porast broja ćelija nalik monocitnim SĆMP (M-SĆMP) (p > 0,05). Kada su analizirane relativne i apsolutne brojnosti ćelija nalik PMN-SĆMP u odnosu na stadijume bolesti KRK (TNM klasifikacija), utvrđena je statistički značajna razlika između kontrolne grupe i bolesnika u III i IV stadijumu bolesti (p = 0,0005 vs. p = 0,0003 i p < 0,0001 vs. P < 0,0001, redom). Takođe, nađena je statistički značajna razlika brojnosti ćelija nalik PMN-SĆMP poređenjem bolesnika u I i II stadijumu bolesti, u odnosu na brojnost tih ćelija kod bolesnika u IV stadijumu KRK (p = 0,0161 vs. P < 0,0001 i p = 0,0065 vs. p < 0,0001, redom). Statistički značajna razlika u relativnom i apsolutnom broju ćelija nalik M-SĆMP uočena je samo između bolesnika u II i IV stadijumu bolesti (p = 0,0014 i p = 0,0002, redom). Najveći broj ćelija nalik SĆMP uočen je u IV stadijumu bolesti, prema TNM klasifikaciji. Uočena je pozitivna korelacija između prisustva tih ćelija i broja organa koji su zahvaćeni metastatskim promenama (p < 0,0001 za relativni i apsolutni broj ćelija nalik PMN-SĆMP i p = 0,003, p = 0,0004 za relativni i apsolutni broj ćelija nalik M-SĆMP). Zaključak. Oboleli od KRK imali su statistički značajan porast broja ćelija nalik PMN-SĆMP u odnosu na zdrave ispitanike. Porast apsolutnih i relativnih vrednosti broja ovih ćelija većim delom prati rast i napredovanje KRK, dok je statistički značajna razlika broja ćelija nalik M-SĆMP uočena samo između II i IV stadijuma bolesti. Apsolutni i relativni broj oba podtipa ćelija sličnih SĆMP značajno koreliše sa brojem organa zahvaćenih metastazama u KRK.
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