食管癌病人手术前后NK细胞、TNF、PGE_2的变化及其临床意义

PRE-AND POSTOPERATTVE NK CELL NUMBER AND PLASMA LEVELS OF TNF AND PGE2 IN PATIENTS WITH ESOPHAGEAL CARCINOMA AND THEIR CLINICAL SIGNIFICANCE

检测６７例食管癌病人手术前、后和２２例根治术后随访病人的外周血自然杀伤（ＮＫ）细胞数量、血浆肿瘤坏死因子（ＴＮＦ）及前列腺素Ｅ２（ＰＧＥ２）水平。发现食管癌病人ＮＫ细胞数量减少，ＴＮＦ、ＰＧＥ２水平升高，与正常对照组相比，差异有非常显著性意义。三项指标水平与肿瘤ＴＮＭ分期密切相关。根治性肿瘤切除术后，ＮＫ细胞数量增多，ＴＮＦ、ＰＧＥ２水平下降，与术前相比，差异有显著性意义，但并未恢复至正常水平。肿瘤复发、转移后，ＮＫ细胞数量再度减少，血浆ＴＮＦ、ＰＧＥ２水平再次升高，而且比临床发现肿瘤复发、转移的时间早２～８个月。此结果表明，动态检测食管癌病人外周血ＮＫ细胞数量和血浆ＴＮＦ、ＰＧＥ２水平，对判断术后疗效、估计预后、及早发现肿瘤复发和转移有较大价值。

Abstract the number of NKcell in peripheral blood,plasma levels of TNF and PGE2 were determined in67 patients with esophageal squamous cell carcinoma of various stages (Ⅱ、Ⅲ、Ⅳ)before and after operation,in 22 postoperative follow-up patients and in 20 healthy volunteers.The findings showed a significantly decreased number of NK cells and higher levels of TNF and PGE2 inpatients with cancer compared with the healthy control subjects (p<0.01).The three parameters were found to be closely related to the TNM staging of the tumors.The number of circulating NK cellsincreased and the plasma TNF and PGE2 levels decreased in patients after radical operation after compared with the preoperative ones,but didn't reach the normal levels.Those whodevelopedtumor recurrence or metastases had a fall in NK cell number and a rise in the plasmaTNF and OGE2 levels compared with disease-free patients and normal controls.Moreover,the decreare of NK cell number and increase of TNF,PGE2 levels occured 2～8 monthw (mean5 momths )before relapse or metastases eas clinically diagnozed.Additionally ,the NK cell number was found to be negatively correlated with the plasme TNF,PGE2 levels,and the TNFconcentration positively corrclated with serum PGE2.We would concllude that determination of num-ber of circulating NK cells and plasma TNF and PGE2 concentration is of great significance on assessing prognosis and monitoring early tumor recurreuce or metastasis.