喉癌围手术期细胞免疫功能改变的意义  

Study the relation between the levels of t-lymphocyte sub-populations and the clinical characteristic

作　　者：郑美桦[1] 栾信庸[1] 

机构地区：[1]济宁市第一人民医院耳鼻喉科,272111

出　　处：《山东医大基础医学院学报》2000年第6期332-335,共4页

摘　　要：目的 :了解喉癌患者围手术期细胞免疫的状况及手术相关因素对患者细胞免疫的影响 ;了解T淋巴细胞水平与喉癌临床特征、病程进展的关系。方法 :应用SAP法检测喉癌术前 2d及术后 12d外周血CD3+、CD4 +、CD8+细胞水平及CD4 +/CD8+比率的改变 ,并联系临床分期、淋巴结转移、复发综合分析。结果 :喉癌患者CD3+、CD4 +、CD8+细胞水平及CD4 +/CD8+比正常对照组明显下降 ;术后CD3+、CD4 +、CD8+有进一步下降的倾向。晚期喉癌患者CD4 +细胞水平、CD4 +/CD8+比率明显下降 (P <0 0 5)。淋巴结转移者CD4 +/CD8+亦下降 ,CD8+细胞水平却相对升高 ;复发患者的CD8+细胞水平相对提高。结论 :喉癌患者T淋巴细胞免疫功能低下 ,全麻、手术创伤及术后复合因素是喉癌术后免疫功能进一步低下的原因。CD4 +、CD8+细胞水平及CD4 +/CD8+比率是表明喉癌患者病期进展、淋巴结转移、复发的免疫学指标。围手术期需行免疫治疗。Objective:To research the status of T lymphocyte sub populations in peripheral blood of laryngeal carcinoma during peri operative period;and to study the relation between the levels of T lymphocyte sub populations and the clinical development characteristics.Method:The level of CD 3 +,CD 4 +,CD 8 + cells,and the CD 4 +/CD 8 + ratio in the peripheral blood were detected in 75 patients with laryngeal carcinoma and 16 healthy persons as controls,at the second day preoperative and the 12th day postoperative.Result:Peripheral blood T cells,phenotypically CD 3 +,CD 4 +,CD 8 + cells and CD 4 +/CD 8 + ratio were significantly decreased in the patients.After operation,the levels of CD 3 +,CD 4 +,CD 8 + cells have a tendency to become lower.The levels of CD 4 + cells and the CD 4 +/CD 8 + ratio were decreased in late laryngeal carcinoma(stage Ⅲ and Ⅳ)compared with early stage patients (stageⅠ and Ⅱ).The CD 4 +/CD 8 + ratio was lower significantly and the levels of CD 8 + cells increased in the lymphatic metastasis. The levels of CD 8 + cells was increasing in the relapsed patients than in the un relapsed ones.Conclusion:The T lymphocyte levels in peripheral blood of patients with laryngeal carcinoma decreased.After the operation,the levels are lower relating to the anesthesia,the injury of operation,and the post operative factors such as painful,nervousness.The levels of CD 4 + cells and the CD 4 +/CD 8 + ratios can be regarded as the immunological parameter in identifying the tumor stages,the relapse,the lymphnode metastasis and predicting postoperative immune status.

关 键 词：喉肿瘤 手术期间 细胞免疫 

分 类 号：R739.65[医药卫生—肿瘤]