放化疗对食管癌患者T淋巴细胞及自然杀伤细胞影响的临床研究  

Clinical research of T lymphocytes and NK cells in patients with esophageal cancer by radio-chemotherapy

作　　者：王忠明[1] 刘桂荣[1] 黄关宏[1] 马建新[1] 刘小林[1] 陈丹丹[1] 周婵[1] 袁春銮[1] 李秀翠[1] 

机构地区：[1]连云港市第二人民医院肿瘤放疗科,江苏省222023

出　　处：《中华临床医师杂志（电子版）》2010年第12期30-33,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：连云港市卫生局重点人才课题(ZC320)

摘　　要：目的探讨食管癌患者外周血T淋巴细胞、自然杀伤(NK)细胞的变化及放化疗对其的影响。方法 68例经病理组织学确诊的食管癌患者采用单纯放疗或同步放化疗治疗,应用流式细胞仪测定其治疗前后外周血T淋巴细胞亚群及NK细胞比例,以健康体检人群为对照分析其变化。结果 (1)食管癌患者外周血T细胞、Th细胞、Th/Ts细胞比值较正常对照组均明显下降(P<0.01),而Ts细胞水平显著升高(P<0.05)。(2)外周血T淋巴细胞亚群及Th/Ts比例与患者性别、肿瘤分期、病理分化程度、病变部位等临床病理参数无明显相关性。(3)放化疗后,患者外周血总T细胞、Th细胞、Th/Ts细胞比值及NK细胞均上升(P<0.01),而Ts细胞降低(P<0.05);单放组总T细胞、Th细胞、NK细胞较同步组升高更显著。结论食管癌患者细胞免疫功能低下,检测T淋巴细胞亚群、NK细胞可用于患者的免疫监测。放疗及化疗应着重围绕提高总T细胞、Th细胞和NK细胞的数量与功能。Objective To study the change of T lymphocyte subsets and NK cells in esophageal cancer patients and the influence after radio-chemotherapy. Methods Sixty-eight cases with histologically confirmed esophageal cancer were treated with radiotherapy alone or concurrent radiotherapy and chemotherapy, measured by flow eytometry before and after treatment of peripheral blood T lymphocyte subsets and NK cell ratio and contrasted to the healthy people. Results （ 1 ） Peripheral blood T ceils in patients with esophageal cancer, Th ceils, Th/Ts was compared with the control group decreased significantly, while the Ts cells were significantly increased. （2） The clinical differences of peripheral blood T lymphocyte subsets, Th/Ts ratio change with patient sex, tumor staging, histological differentiation, pathological lesions, were no significant meaning. （3） After radiotherapy and chemotherapy, the patient＇s peripheral blood T cells, Th cells, Th/Ts cell ratio and NK cells were increased, while the Ts cells decreased, the difference was significant. Conclusions Cellular immune function in patients with esophageal cancer is suppressed, detection of T lymphocyte subsets, NK cells can be used for immune monitoring of patients with esophageal cancer.

关 键 词：食管肿瘤 T淋巴细胞亚群 杀伤细胞 天然 化学疗法 辅助 放射疗法 辅助 

分 类 号：R735.1[医药卫生—肿瘤]