中晚期肺癌患者手术前后细胞免疫功能变化

Changes of cellular immunological function after surgical operation in patients with locally advanced lung cancer

目的:观察中、晚期肺癌患者手术前后细胞免疫功能的变化状况。方法:选肺癌组(A组)、肺良性病变组(B组)和正常对照组(C组)各20例;以间接免疫荧光法测定C组、A组及B组术前、A组及B组术后第10d以及A组术后第17d的外周静脉血的T淋巴细胞亚群水平(CD+3、CD+4、CD+8、CD+4/CD+8比值)。结果:A组术前CD+3低于B组、CD+8高于C组和B组、CD+4/CD+8比值低于C组和B组;A组术后第10、第17dCD+3高于术前、CD+8明显低于术前;CD+4/CD+8比值A组术后第17d较术前增高。CD+4A组比较C组、CD+8A组术后第10d比较术后第17d、CD+4A组术后第10、第17d比较术前,均无明显差别。结论:中、晚期肺癌患者外科手术切除肿瘤后患者的免疫抑制有所解除,免疫功能得到改善。从免疫学观点看,中、晚期肺癌的手术治疗具有积极意义。

AIM: To study the change of cellular immunological function in patients with locally advanced lung cancer before and after operations. METHODS: A lung cancer group of 20 cases with locally advanced lung cancer (group A), a benign disease group of 20 cases with lung benign disease (group B) and a normal group of 20 cases from healthy volunteers (group C) were set up. The levels of the peripheral blood T lymphocyte subsets (CD^+_3, CD^+_4, CD^+_8, CD^+_4/ CD^+_8 ratio) were detected in the group A before operation and on the 10th day and 17th day after operation by indirect immuno-fluorescence assay and contrasted with the group B and group C. RESULTS: The levels of T lymphocyte subsets in group A were abnormal before operation, CD^+_3, CD^+_4/ CD^+_8 ratio were significantly lower than those in group B and group C (P<0.05), and CD^+_8 was significantly higher (P<0.05). CD^+_3 significantly increased (P<0.05) and CD^+_8 decreased (P<0.05) on 10th day and 17th day after operation. CD^+_4/ CD^+_8 ratio significantly increased on 17th day after operation (P<0.05). There was no significant difference of the levels of T lymphocyte subsets between the 10th day and 17th day after operation. CONCLUSIONS: The patients with locally advanced lung cancer have a remarkable impairment of immunological function, which mainly show stronger immunosuppression and have some recovery after operation. In the view of immunology, the surgical resection for locally advanced lung cancer shows active significance.