大肠癌患者手术前后外周血NK细胞和TNF的变化及意义  

Clinical significance of pre-and postoperative peripheral blood NK cell and TNF in patients with colorectal carcinoma

作　　者：徐辉[1] 

机构地区：[1]成都军区昆明总医院普通外科,650032

出　　处：《消化外科》2003年第2期104-106,共3页Journal of Digestive Surgery

摘　　要：目的　通过检测外周血自然杀伤细胞 (naturalkillercell,NKcell)数和肿瘤坏死因子(tumornecrosisfactor ,TNF)水平来探讨其在大肠癌中的表达机制及临床意义。方法　应用碱性磷酸酶-抗碱性磷酸酶 (APAAP)法和放射免疫法 (RIA)分别检测 4 2例大肠癌患者血清NK细胞数和TNF水平 ,并与大肠良性疾病患者及正常人作对比分析。结果　 (1)大肠癌肿组外周血NK细胞数较良性疾病组及正常对照组显著降低 (P <0 .0 1) ,TNF水平显著升高 (P <0 .0 1) ,良性疾病组与正常对照组相比 ,差异无意义 ;(2 )根治性肿瘤切除术后两周 ,外周血NK细胞升高 ,TNF水平下降 ,与术前相比 ,有显著性差异 ;非根治性肿瘤切除术者与术前相比无差异 ;(3)有淋巴结或远处转移者外周血NK细胞数较非转移者显著降低 (P <0 .0 1) ,而TNF水平显著升高 (P <0 .0 1) ;(4)外周血NK细胞数与TNF水平在大肠癌患者中呈显著负相关 (P <0 .0 5 )。结论　检测外周血NK细胞数和TNF水平可评估大肠癌患者细胞免疫功能 ,对判断术后疗效及预后有较大价值。Objective To evaluate the clinical significance of circulating natural killer cell (NK cell) and the plasma tumor necrosis factor (TNF) in patient with colorectal carinoma. Methods APAAP way and RIA way were applied to assay respectively the number of NK cell in peripheral blood and plasma level of TNF in forty-two patients with colorectal cancer, and the results were compared with these in paeitns with benign disease or normal subjects. Results (1) The findings showed a significantly decreased number of NK cell and higher levels of TNF in patients with cancer compared with the benign disease and the normal subject (P<0.01). There were no significant difference between patients with benign disease and normal subjects (P>0.05). (2) On the 14th day after radical surgery the number of circulating NK cells was significantly increased and the plasma TNF level significantly decreased compared with those of preoperation (P<0.01), nevertheless there was no significant difference in patients who underwent non-radical operation. (3) The number of NK cells significantly decreased and the plasma level of TNF significantly increased in patients with lymph nodes or distant metastasis compared with those without metastasis. (4) The number of NK cell was found to be negatively correlated with the plasma level of TNF in patients with colorectal cancer (P<0.05). Conclusions Assying the number of circulating NK cells and the plasma level of TNF can estimate the cellular immunological function in patients with colorectal carinoma, and the two parameters is of great importance in assessing postoperative effectiveness and prognosis.

关 键 词：大肠癌 自然杀伤细胞 肿瘤坏死因子 

分 类 号：R735.34[医药卫生—肿瘤]