非小细胞肺癌手术治疗与Th1/Th2的漂移

The Pre-and Postoperative Variations of Th1/Th2 on the Cellular Immune Function in the Patients with Lung Cancer

目的 :探讨肺癌患者手术前后是否存在 Th1/ Th2免疫失衡及根治性切除肿瘤负荷后是否能出现 Th2型向 Th1型的漂移。方法 :用流式细胞仪检测 30例根治切除的肺癌患者术前、术后不同时期外周血淋巴细胞亚群中各种细胞因子。结果 :能代表 Th1功能的 IL - 2和 IL - 12术后的表达水平较术前明显升高 ,而 IFN-γ和 TNF术后的表达水平则较术前降低 ;能代表 Th2功能的 IL - 4和 IL - 10术前的表达水平远高于术后 ,差别均具有显著性意义 (P≤ 0 .0 1)。结论 :肺癌患者手术前即存在 Th1/ Th2免疫失衡 ,而根治性切除肿瘤负荷即解除肿瘤源性的免疫抑制后 ,可以改善患者细胞免疫功能而促使 Th2型向 Th1型的漂移。

Objective:To study the pre- and postoperative variations of Th1/Th2 cytokines on cellular immunity change in patients with lung cancer. Method:The peripheral blood lymphocyte subsets were examined in 30 patients with lung cancer before and after operation by flow cytometric analysis. Results: The expression of Th1 in preoperation was significantly lower than that in postoperation but the expressions of IFN-γand TNF in preoperation were significantly higher than those in postoperative group (P≤0.01). The expression of Th2 was significantly higher than that in postoperative group (P≤0.01). The degree of these changes would become more distinct in 2 weeks after removing the tumor. Conclusion:These data suggested that patients with lung cancer had remarkably immunity disorder before operation and surgical operation could not only get rid of tumor but also free them from immunosuppression. The immune balance would return after operation.