肺癌患者围手术期免疫功能动态检测及临床价值  

Clinical significance of immunologic function of patients with lung cancer during perioperation period

作　　者：郑翠英[1] 蔡忠[1] 张逊[1] 艾静[1] 囤玉玲[1] 张连祥[1] 

机构地区：[1]天津市胸科医院检验科,300051

出　　处：《江西医学检验》2005年第1期11-14,共4页Jiangxi Journal of Medical Laboratory Sciences

摘　　要：目的探讨肺癌患者围手术期T淋巴细胞亚群、NK细胞和可溶性白细胞介素2受体(sIL-2R)的动态变化其临床价值。方法应用荧光免疫法和酶联免疫吸附法(ELISA)对15例健康对照组、15例肺良性肿瘤和60例肺癌患者围手术期T淋巴细胞亚群、NK细胞和sIL-2R进行检测。结果肺癌患者CD3+、CD4+、CD4+/CD8+和NK细胞明显低于肺良性肿瘤患者和健康对照组(P<0.05),sIL-2R高于肺良性肿瘤患者和健康对照组(P<0.01);肺癌患者术后第二天的CD3+、CD4+、CD4+/CD8+和NK细胞较术前更低(P<0.01),sIL-2R迅速降低(P<0.01),至术后7～14天除sIL-2R外其它指标恢复到术前水平(P>0.05),术后28天CD3+、CD4+、CD4+/CD8+和NK细胞较术前升高,sIL-2R接近术后2天水平(P>0.05);肺癌患者CD3+、CD4+水平无论早期或晚期均比正常对照组下降(P<0.05),CD4+/CD8+比值只有晚期比对照组下降(P<0.01),早期与对照组相似(P>0.05);术后28天根治性切除和姑息性切除CD3+、CD4+、CD4+/CD8+和NK细胞较剖腹探察组升高(P<0.01),sIL-2R明显降低(P<0.01)。结论围手术期T细胞亚群、NK细胞和sIL-2R的动态监测是反映肺癌患者免疫功能变化的客观指标,对指导患者的临床治疗有重要的参考价值。Objective To explore the perioperation period changes and significance of T subgroups,NK cell and soluble interleukin-2 receptor (sIL-2R) in patients with lung cancer. Methods T subgroups, NK cell and soluble interleukin-2 receptor from 60 patients with lung cancer during perioperation period, 15 patients with benign lung tumour and 15 healthy people were detected by immunofluorescence and ELISA. Results CD3+, CD4+, CD4+/CD8+ and NK cell in lung cancer group were significantly lower than those in benign lung tumour and healthy group(P<0.05); sIL-2R was higher than that in benign lung tumour and healthy group(P<0.01). At postoperative 2nd day CD3+,CD4+, CD4+/CD8+, NK cell and sIL-2R in lung cancer group were significantly decreased than those before operation(P<0.01); during postoperative 7 to 14 days, all indexs basically recovered to the preoperative level(P>0.05) except sIL-2R. At postoperative 28th day, CD3+, CD4+, CD4+/CD8+and NK cell were increased than those before operation(P>0.05), sIL-2R had no significantly changed than that of postoperative 2nd day. CD3+ and CD4+ in lung cancer group no matter in early or later stage decreased than that of those in healthy group(P<0.05), CD4+/CD8+ in later lung cancer decreased than that in healthy group(P<0.05). there was significant difference between the groups of radical and palliative operation and the group of the thoracic exploration at postoperative 28th day(P<0.05), sIL-2R decreased(P<0.01)and CD3+, CD4+, CD4+/CD8+ and NK cell increased(P<0.01). Conclusions Detections of CD3+, CD4+, CD4+/CD8+, NK cell and sIL-2R during perioperation period may be useful for studying the changes of immunologic function and predicting the prognosis in patients with lung cancer, it can be useful to conducting clinical treatment for lung cancer.

关 键 词：SIL-2R NK细胞 对照组 肺癌患者 CD3^+ CD4^+ 围手术期 水平 能动 结论 

分 类 号：R734.2[医药卫生—肿瘤] R735[医药卫生—临床医学]