42例胃肠道肿瘤患者手术前后细胞免疫功能的动态检测  

Dynamic observation of the cell immunity system of the patients with gastrointestinal tumor at stage Ⅲ

作　　者：钱印榕[1] 王福龙[1] 王君[1] 黄泽文[1] 

机构地区：[1]福建中医学院附属第二人民医院普外科,福州350003

出　　处：《临床肿瘤学杂志》2007年第9期666-668,共3页Chinese Clinical Oncology

摘　　要：目的:评价中晚期胃肠道肿瘤患者手术前后的细胞免疫功能。方法:对42例确诊为原发性胃肠道肿瘤并适合手术治疗者,分别于术前、手术后1周、2周、3周及4周测定外周血NK细胞活性、CD3+、CD4+、CD8+及CD4+/CD8+比值,分析手术前后细胞免疫功能的动态变化,并与正常对照组比较,探讨患者细胞免疫功能与预后的关系。结果:与对照组比较,胃肠道肿瘤患者术前NK细胞活性、CD3+、CD4+显著降低(P<0.05),而CD8+明显升高(P<0.05),致CD4+/CD8+比值进一步降低(P<0.01);患者细胞免疫功能在手术后2周明显受抑制,术后3周开始有改善,术后4周可恢复至正常水平;患者若出现肿瘤复发或转移,其细胞免疫功能可再次呈现受抑制状态。结论:胃肠道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 evaluate the cell immunity system of the patients with gastrointestinal tumor at stage Ⅲ. Methods： 42 patients with gastrointestinal tumor at stage Ⅲ were observed which were still apt for the treatment by operation. Their peripheral blood NK cell activity, CD3^＋ , CD4^＋ , CD8^＋ and CD4^＋/CD8^＋ were determined respectively prior to and after the operation,specifically one week after the operation, two weeks after the operation, three weeks after the operation and four weeks after the operation. By analysing the dynamic changes of cell immunity function and comparing with normal control group, the relationship was explored between cell immunity function of the patient and the prognosis. Results：Compared with the control group, prior to the operation on the gastrointestinal tumor patients, their NK cell activity, CD3 ^＋ , and CD4^＋ decreased distinctly whereas the CD8^＋ increased clearly, and consequently the ratio CD4^＋/CD8^＋ diminished （P 〈 0. 01 ） ; Two weeks after the operation, the immunity function of the patients undergone restrains, and three weeks after the operation, the immunity function was ameliorated while four weeks after the operation the immunity system of the patients recovered to its healthy function; Given tumor recrudescence or metastasis, the immunity function of the cells might take again on the phenomenon of being restrained. Conclusion： There must exist the relevancy between the restrain imposed on the cell immunity system of the patients with gastrointestinal tumor at Ⅲ stage and tumor load, and the operations on the one hand cure tumor while on the other bring the restrain to the immunity system of the patients.

关 键 词：胃肠道肿瘤 围手术期 细胞免疫功能 

分 类 号：R735.2[医药卫生—肿瘤] R735.3[医药卫生—临床医学]