Abstract
To elucidate alteration of purine nucleoside phosphorylase (PNP) activity of peripheral lymphocytes and helper/inducer and suppressor/cytototxic T cells in patients with thyroid tumors, the author examined PNP activity, and $CD4^+\;and\;CD8^+$ cells of peripheral blood in 20 cases of simple goiter, 9 cases of thyroid adenoma and 20 cases of thyroid cancer as well as 11 cases of adult healthy subjects as control. Diagnoses were established on the basis of commonly accepted clinical and biochemical criteria in simple goiter and were confirmed histopathologically in thyroid adenoma and cancer. All blood was obtained from veins of the patients and control subjects in Pusan National University Hospital during the period of January to August, 1991. The results obtained were summarized as follows: 1) The PNP activity was significantly decreased or tended to be decreased in thyroid adenomas and cancers as compared with control subjects and simple goiters. 2) The percentage of CD8 cells was significantly decreased or tended to be decreased in thyroid cancers as compared with simple goiters, thyroid adenomas and control subjects. 3) The CD4/CD8 ratio was significantly increased or tended to be increased in thyroid cancer as compared with simple goiters, thyroid adenomas and control subjects. On the basis of the results, it can be suggested that the immunodysfunction in thyroid cancer may be due to decreased suppressor/cytotoxic T cells, and the estimation of PNP activity of peripheral lymphocyte is a helpful test in detecting the immune status in thyroid tumors.
저자는 1991년 1월부터 동년 8월 사이에 부산대학교 병원 내과 외래에서 임상증상, 이학적 소견 및 각종 검사소견과 병리조직학적으로 진단된 단순 증식성 갑상선종 환자 20예, 갑상선선종 환자 9예 및 갑상선암환자 20예와 건강대조군 11례에서 말초혈 림프구의 PNP활성을 측정하고 $CD4^+$ 및 $CD8^+$ 세포를 동시에 검색하여 분석할 성적을 다음과 같이 요약한다. 1) 말초혈 림프구의 PNP 활성은 건강 대조군 및 단순 증식성 갑상선종 보다 갑상선선종 및 암환자에서 의의있게 증가하거나 증가하는 경향이 있었다. 2) 말초혈의 $CD8^+$ 세포 비율은 갑상선암환자에서 건강 대조군, 단순 증식성 갑상선종 및 갑상선선종환자 보다 각각 의의 있게 감소하거나 감소하는 경 향이 있었다. 3) 말초혈의 CD4/CD8비는 갑상선암환자에서 건강 대조군, 단순 증식성 갑상선종 및 갑상선선종환자보다 각각 의의 있게 증가하거나 증가하는 경향이 있었다. 이상의 결과에 의하면 갑상선암환자에서는 말초혈의 억제/세포상해 T 세포의 감소에 의한 세포성 면역능의 이상이 있고, 말초혈 림프구의 PNP활성의 측정은 갑상선종양환자의 면역 상태를 파악하는데 도움이 되는 검사라고 생각된다.