摘要
目的评价Ⅲ期胃肠肿瘤患者围术期的细胞免疫功能。方法对25例确诊为Ⅲ期原发性胃肠肿瘤并适合手术治疗者,分别于术前1周、术后2、4周测定外周血自然杀伤(NK)细胞、CD3+、CD4+和CD8+细胞计数,并计算CD4+/CD8+比值,观察患者细胞免疫功能与预后的关系。结果术前1周胃肠肿瘤患者测得的NK细胞、CD3+、CD4+、CD8+细胞数与对照组相比,差别有显著性意义(P<0.05);CD4+/CD8+比值与对照组比较差别亦有显著性意义(P<0.01)。胃肠肿瘤患者于术前1周、术后2周和4周测得的NK细胞、CD4+、CD8+细胞数及CD4+/CD8+比值间差别有显著性意义(P<0.05);术后2周,患者外周血NK细胞和CD4+细胞数与术前1周相比,差别有显著性意义(P<0.05),术后4周CD8+细胞数及CD4+/CD8+比值与术前1周相比差别有显著性意义(P<0.05)。观察组5例患者术后1年内出现肿瘤复发或转移,其NK细胞、CD4+、CD8+细胞数与未复发、转移者相比差别有显著性意义(P<0.05)。结论Ⅲ期胃肠肿瘤患者细胞免疫功能受抑制与肿瘤负荷存在一定相关性,手术在治疗肿瘤的同时也抑制了患者的免疫功能。
Objective To study the peroperative changes of the cell immune function in patients with stage Ⅲ gastrointestinal tumor. Methods Twenty - five patients with stage Ⅲ gastrointestinal tumor which could be resected were enrolled to study the relationship between the outcome and the cell immune function. The peripheral blood NK cell activity was tested, the CD3^＋, CD4^＋ and CD8^＋ cell count were performed and the CD4^＋/CD8^＋ ratio was calculated on the day 7 prior to and the day 14, 28 after the operation. Results The peripheral blood NK cell activity, the CD3^＋ and CD4^＋ cell count decreased significantly （ P 〈 0. 05 ）, the CDs cell count increased significantly （ P 〈0. 05） and the CD4^＋/CD8^＋ ratio diminished significantly （ P 〈0. 01 ） on the preoperative day 7 in the tumor group compared to the control group. The cell immune function was of significant difference in the different peroperative period in the tumor patients （ P 〈 0. 05 ）. The peripheral blood NK cell activity and the CD4^＋ cell count increased significantly on postoperative day 14 than that on preoperative day 7 （ P 〈0.05 ）. The CD8^＋ cell count and the CD4^＋/ CD8^＋ ratio increased significantly on postoperative day 28 than that on preoperative day 7 （ P 〈 0.05）. The NK cell activity, the CD4^＋ and CD8^＋ cell count decreased significantly in the patients with tumor recurrence or metastasis than that without tumor recurrence or metastasis （ P 〈 0. 05 ）. Conclusion The cell immune function was suppressed in patients with Ⅲ stage gastrointestinal tumor. The suppressant degree correlated with the tumor load. The operation could restrain the immune function of the patients.
出处
《中国全科医学》
CAS
CSCD
2007年第2期110-112,共3页
Chinese General Practice
基金
福建省科技厅重点资助项目(2005Y028)
关键词
胃肠肿瘤
围术期
细胞免疫功能
Gastrointestinal neoplasms
Peroperaiive period； Cell immune function
