胃癌患者外周血T淋巴细胞亚群变化与预后关系探讨  

The Investigation of Correlation Between T-Lymphocyte Subsets and Prognosis in Gastric Cancer

作　　者：肖接承[1] 吕光成[1] 钱海鑫[1] 田力平[1] 王爱青[2] 李建勇[2] 刘征辉[2] 

机构地区：[1]苏州医学院附属第一医院普外科 [2]苏州医学院核医学生物技术重点实验室

出　　处：《苏州医学院学报》1995年第5期819-822,998,共4页Acta Academiae Medicinae Suzhou

摘　　要：流式细胞术(FCM)测定68例胃癌患者术前及41例对照组外周静脉血 T 淋巴细胞及其亚群,并观察了胃癌患者术后(第7～10天)CD_4/CD_B的变化。与对照组相比,进展期胃癌 CD_3^+、CD_4^+细胞数量明显降低,CD_5^+细胞轻度升高,导致 CD_4/CD_6比值显著降低,而且 CD_4/CD_比值的这种改变与病期、肿瘤的浸润深度、淋巴结转移、肿瘤大小及生长方式相关,而与年龄、性别、肿瘤的位置及组织学分类无关。胃癌术后 CD_4/CD_比值在Ⅲ_b、Ⅳ期患者有进一步降低的趋势。提示,进展期胃癌免疫功能低下与 CD^+细胞数量降低或功能缺陷相关,而且随疾病的发展进一步加深。CD_4/CD_比值变化与胃癌生物学特征相关,因而 T 淋巴细胞亚群是一预后因素;病期、淋巴结转移、切端癌残留等因素影响术后 CD_/CD_比值恢复。结果表明,胃癌患者免疫状态是影响胃癌预后的一个重要细胞生物学因素。The present study was carried out to find out whether there is correlation between peripheral bloo lymphocytes and prognosis in gastric cancer.The lymphocytes and their subsets were determined in peripheral blood in 68 gastric cancer patients before and after operation and 41 controls by using flow cytometry(FCM).It seems that the percentage of T-cells(CD_8^+)suppression shows no difference in patients with gastric cancer in various stages that contrasts to the control.but the percentage of T- lymphocytes(CD_3^+)and helper T-cells(CD_4^+)and the CD_4/CD_8 ratio decreased significantly in the advanced gastric cancer.Decrease of the CD_4/CD_8 ratio was well correlated with tumor invasion lymph node metastasis、tumor size and growth fashion、but not with sex、age、tumor location,or histological differentiation、The recovery of the CD_4/CD_8 ratio in the period 7—10 days after operation was different in different stages,and was related to stages,lymph node metastasis,and stump reside etc.nIt means that T-lymphocytes and their subsets are an important the cellular biological factor affecting the prognosis of gastric cancer.The results suggest that the immunotherapy which stimulates the deficient immune symtem may play an important role before and after operation or in the multimodality treatment of patients with advanced gastric cancer and the cases treated by this method have better prognosis.

关 键 词：T淋巴细胞亚群 胃癌 预后 流式细胞术 

分 类 号：R735.207[医药卫生—肿瘤]