心理肿瘤学与心理神经内分泌免疫学（PNEI）的关系：通过罗夏测验评估有自罚行为的癌症患者中 T 调节性淋巴细胞活性增强。

Relationship between psychoncology and psychoneuroendocrinoimmunology (PNEI): enhanced T-regulatory lymphocyte activity in cancer patients with self-punishement, evaluated by Rorschach test.

机构信息

Psychological Service, Maggiore Policlinico Hospital, Milan, Italy.

出版信息

In Vivo. 2010 Jan-Feb;24(1):75-8.

PMID:20133980

Abstract

BACKGROUND

Psychological studies have documented the presence of a self-punishment profile in cancer patients. Recent immuno-oncological studies have shown that within the group of CD4(+) cells, which play a fundamental role in the generation of anticancer immunity, there is a subtype of cells that in contrast mediates the suppression of the anticancer immunity, the so-called T-regulatory cells (T-reg), which may be identified as CD4(+)CD25(+) cells.

PATIENTS AND METHODS

On this basis, we performed a psychoncological study to evaluate CD4(+)CD25(+) cell numbers in relation to the response to Rorschach's test in a group of 30 cancer patients suffering from the most frequent tumor histotypes.

RESULTS

Normal values obtained in our laboratory (95% confidence limits) of T-reg lymphocytes and CD4(+)/CD4(+)CD25(+) were <240/mm(3) and >4mm(3), respectively. The psychological profile of self-punishment was found in 18/30 patients (60%). The percentage of patients with abnormally high CD4(+)CD25(+) values observed in the group with self-punishment was significantly higher than that found in patients without self punishment (11/18 vs. 3/12 (25%), p<0.05). In the same way, the percentage of patients with abnormally low CD4(+)/CD4(+)CD25(+) ratios was significantly higher in the group with self-punishment (16/18 vs. 4/12, p<0.01). The mean numbers of T-reg lymphocytes observed in the group with self-punishment was significantly higher than that found in patients who had no self-punishment (314+/-39 vs. 173+/-27, p<0.05). In addition, the mean CD4(+)/ CD4(+)CD25(+) ratio was significantly lower in patients with self-punishment than in the other group (2.6+/-0.2 vs. 5.2+/-0.8, p<0.025). On the contrary, no significant difference was seen in the mean number of CD4(+) lymphocytes.

CONCLUSION

The study suggests that self-punishment may inhibit the generation of an effective anticancer immune response by stimulating the activation and proliferation of T-reg lymphocytes, which in turn stimulate tumor dissemination by suppressing anticancer immunity. The abnormally high number of T-reg lymphocytes in patients with self-punishment would suggest a specific immune alteration, as suggested by the evidence of a normal profile for other immune parameters, such as total CD4(+) lymphocytes.

摘要

背景

心理研究已经记录了癌症患者中存在自我惩罚特征。最近的免疫肿瘤学研究表明，在发挥抗肿瘤免疫作用的 CD4(+)细胞群中，存在一种亚型细胞，其介导抗肿瘤免疫的抑制，即所谓的 T 调节细胞（T-reg），可以通过 CD4(+)CD25(+)细胞来识别。

患者和方法

在此基础上，我们进行了一项心理肿瘤学研究，以评估一组患有最常见肿瘤组织类型的 30 名癌症患者的 CD4(+)CD25(+)细胞数量与罗夏测试反应之间的关系。

结果

我们实验室获得的正常 T-reg 淋巴细胞和 CD4(+)/CD4(+)CD25(+)值（95%置信区间）分别为<240/mm(3)和>4mm(3)。在 30 名患者中，有 18/30 名（60%）患者发现自我惩罚的心理特征。在有自我惩罚的患者组中，观察到的异常高 CD4(+)CD25(+)值的患者百分比明显高于无自我惩罚的患者（11/18 与 3/12（25%），p<0.05）。同样，在有自我惩罚的患者组中，CD4(+)/CD4(+)CD25(+)比值异常低的患者百分比明显高于无自我惩罚的患者（16/18 与 4/12，p<0.01）。有自我惩罚的患者组中观察到的 T-reg 淋巴细胞的平均数量明显高于无自我惩罚的患者（314+/-39 与 173+/-27，p<0.05）。此外，有自我惩罚的患者的 CD4(+)/CD4(+)CD25(+)比值明显低于另一组（2.6+/-0.2 与 5.2+/-0.8，p<0.025）。相反，CD4(+)淋巴细胞的平均数量没有明显差异。