单纯骨转移瘤患者放射性药物治疗与免疫功能的变化分析  

Changes of immunologic parameters in patients with simple bone metastases treated with ^(89)SrCl_2

作　　者：李勇[1] 房娜[2] 李卫哲[3] 杨海山[1] 高凤彤[2] 

机构地区：[1]吉林大学中日联谊医院放射科,长春130033 [2]吉林大学中日联谊医院核医学科,长春130033 [3]天津骨科医院

出　　处：《中华肿瘤杂志》2005年第12期731-733,共3页Chinese Journal of Oncology

基　　金：黑龙江省十五攻关资助项目(GC02C147-01)

摘　　要：目的探讨单纯骨转移瘤患者经放射性药物氯化89锶(89SrCl2)治疗后的免疫功能变化及其与疗效的关系。方法经临床确诊的、以骨转移瘤为首发症状患者25例,采用放射性药物89SrCl2治疗。选择20例体检正常者作为对照组。分别测定单纯骨转移瘤患者治疗前、后及对照组T淋巴细胞亚群CD4+、CD8+和CD4+/CD8+值,并比较有效组与无效组患者间免疫学指标变化。结果对照组CD4+、CD8+和CD4+/CD8+分别为(38.83±8.95)%、(32.19±8.51)%和1.29±0.47。单纯骨转移瘤患者治疗前CD4+、CD8+和CD4+/CD8+分别为(31.12±8.12)%、(41.75±10.91)%和0.84±0.22,治疗后分别为(36.21±8.71)%、(35.08±10.14)%和1.19±0.27。对照组与单纯骨转移瘤治疗前、单纯骨转移瘤治疗前与治疗后相比,差异有统计学意义(P<0.05)。根据疼痛得分,将单纯骨转移瘤患者分为治疗有效组和无效组。在治疗前,有效组与无效组的免疫指标差异无统计学意义(P>0.05);而治疗后,有效组CD4+、CD8+、CD4+/CD8+和病灶数分别为(37.81±5.18)%、(33.17±6.38)%、1.33±0.31和6.64±3.11(个),无效组分别为(32.09±5.72)%、(39.99±5.38)%、0.82±0.22和9.87±3.46(个),两组免疫指标差异有统计学意义(P<0.05),治疗有效组的病灶数减少程度明显好于无效组(P<0.05)。结论89SrCl2治疗后,骨转移瘤患者免疫功能得到恢复。Objective To investigate the influence of ^89SrCl2 （strontium-89 chloride） on immune functions in patients with simple bone metastases. Methods Twenty-five patients diagnosed as simple bone metastases with un-detectable primary tumors were treated with s9 SrC12. The CI）4^＋ , CD8 ^＋ , CD4^＋/CD8^＋ lymphocyte subsets were assessed before and after ^89SrCl2 treatment. Twenty normal individuals served as controls. Results The CD4^＋ , CD8^＋ and CD4 ^＋/CD8^＋ in the control group were （38. 83 ± 8.95）% , （32.19 ±8.51） % and 1.29 ±0.47, respectively. In patients, they were （31.12±8.12） %, （41.75± 10.91） % and 0.84±0.22 before treatment, and （36.21±8.71） %, （35.08±10.14） % and 1.19±0.27 after treatment, respectively （P 〈 0.05 ）. The patients were divided into treatment effective and non- effective groups by pain score. Before treatment, the immunologic parameters in the two groups had no significant differences（P 〉 0.05）. After treatment, the frequencies of CD4^＋ and CD8^＋ subsets, CD4 ^＋ to CD8^＋ ratios and the number of metastatic loci in the effective group were （37.81 ± 5. 18） % , （33.17 ± 6.38） %, 1.33 ±0.31 and 6.64 ±3. 11, respectively, while in the treatment non-effective group, they were （32.09 ±5.72） % , （39.99 ±5.38） % , 0.82 ±0.22 and 9.87 ± 3.46, respectively （P 〈0.05）. Conclusion The immune functions in patients with simple bone metastases are inhibited. Treatment with ^89SrCl2 may improve their immunity to certain extent. The degree of recovery in the treatment effective patients was better than that in the treatment non-effective cases.

关 键 词：骨肿瘤 肿瘤转移 免疫功能 ^89SRCL2 

分 类 号：R738.1[医药卫生—肿瘤]