摘要
目的探讨食管癌患者外周血T淋巴细胞亚群、肿瘤坏死因子(TNF)改变的规律性及其相关因素。方法将75例食管癌患者、55名健康志愿者纳入本研究。对患者术前,术后3、7、14天外周血样按APAAP及酶联免疫法,检测T淋巴细胞亚群和血浆TNF。将所得结果与正常人组作对比研究。结果与正常人相比,患者外周血CD_3^+、CD_4^+明显减少;而CD_8^+明显增加;CD_4^+/CD_8^+比值明显下降。术后3天之T细胞亚群变化尤为明显。随着时间的推移有所恢复,但仍较正常人组为低。免疫损害与其TNM分期、癌细胞分化程度密切相关。TNF水平亦较正常人高,且与肿瘤恶性程度、病期成正相关。结论食管癌患者存在免疫功能低下,麻醉和手术创伤将使机体免疫功能在术后短时期内受到抑制。动态检测血浆T细胞亚群、血浆TNF对判断手术疗效、评估预后有一定价值。
Objective To evaluate the clinical implication of the changes in peripheral blood lymphocyte subsets and TNF during the perioperative period of esophageal carcinoma. Methods 75 patients underwent esophagectomy for cancer,and 55 healthy subjects were included in this study. Blood samples were withdrawn from peripheral vein before operation, and 3, 7, 14 days after operation. Using APAAP and ELISA, T lymphocyte subsets and serum TNF were determined. Results CD3+, CD4+, CD4+/CD8+ ratio in the patients were lower than in control group, TNF were higher in the patiems (P<0.05). The change in lymphocyte subsets was specially obvious (P<0.05) 3 days after operation. The lymphocyte subsets closely turned to the levels before operation at the 7th day after esophagectomy. Conclusion There were immune disturbances in the patients with esophageal carcinoma. Surgical trauma can aggravate the immune disturbances of the patients with esophageal carcinoma. Dynamic determination of T lymphocyte subsets and serum TNF level could evaluate the operative therapeutic effects and prognosis.
出处
《中华实验外科杂志》
CSCD
北大核心
1998年第3期226-228,共3页
Chinese Journal of Experimental Surgery
基金
湖北省教委资助项目
