淋巴化疗对食管癌患者术后免疫功能的影响  

Effects of Lymphatic Chemotherapy on Immune Functions of Patients after Esophageal Carcinoma Resection

作　　者：郑希[1] 袁勇[1] 胡杨[1] 赵雍凡[1] 

机构地区：[1]四川大学华西医院胸外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2014年第2期233-237,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川省卫生厅科研课题(130098)~~

摘　　要：目的 探索术中淋巴化疗对食管癌患者术后免疫功能的影响。 方法 前瞻性纳入2013年3～10月于华西医院胸外科接受食管癌术中淋巴化疗的病例及同期未接受淋巴化疗的食管癌手术病例。纳入患者分为紫杉醇淋巴化疗组、氟尿嘧啶淋巴化疗组及未接受淋巴化疗的对照组。比较淋巴化疗组与对照组患者术前、术后第3 d和第7 d外周血体液和细胞免疫学代表性指标的变化。共纳入分析病例37例，男25例，女12例；年龄42～76（61.89±7.95） 岁。紫杉醇淋巴化疗组15例，氟尿嘧啶淋巴化疗组15例，对照组7例。 结果 3组术后所有免疫学指标均有不同程度降低。淋巴化疗组与对照组相比，免疫球蛋白浓度下降差异无统计学意义（P＞0.05），CD8＋T细胞计数在淋巴化疗组术后恢复快，CD3＋T细胞计数在氟尿嘧啶淋巴化疗组恢复较快。 结论 淋巴化疗有利于食管癌患者术后T细胞的细胞毒作用的恢复，对体液免疫可能无促进作用。Objective To explore the effects of intraoperative lymphatic chemotherapy （LC） on immune functions of patients after esophageal carcinoma resection. Methods Patients who underwent intraoperative LC during esophageal carcinoma resection in the Department of Thoracic Surgery of West China Hospital from March to October,2013 were prospectively included in this study, and patients who underwent esophageal carcinoma resection without intraoperative LC during the same period were also included as the control group. All the patients were divided into a pacitaxel LC group,a fluorouracil LC group,and a control group without LC. A total of 37 patients were included in this study including 25 male and 12 female patients with their age of 42-76 （61.89±7.95） years. There were 15 patients in the pacitaxel LC group,15 patients in the fluorouracil LC group,and 7 patients in the control group. Representative indexes of humoral immunity and cellular immunity in peripheral blood of all the patients were examined preoperatively and on the third and seventhpostoperative day, and then compared among the 3 groups. Results All the immune indexes of the 3 groups decreased after surgery to different extent. There was no statistical difference in preoperative and postoperative difference of immunog-lobulin concentration between LC groups and the control group （P〉0.05）. CD8＋ T cell count recovered more rapidly after surgery in LC groups than the control group. CD3＋ T cells recovered most rapidly after surgery in the fluorouracil LC group. Conclusion LC is beneficial for the recovery of cytotoxic effects of T lymphocytes but may not promote humoral immunity for patients after esophageal carcinoma resection.

关 键 词：食管癌 淋巴化疗 免疫球蛋白 T细胞亚群 

分 类 号：R735.1[医药卫生—肿瘤]