胃癌术中应用IL-2肠系膜注射对机体免疫状态的影响

Effect of IL-2 injection into mesentery during operation on cellular immune function in patients with gastric cancer

目的:评价术中应用IL2肠系膜注射治疗对胃癌患者机体免疫状态的影响及其意义.方法:选择确诊的胃癌患者60例,按单盲法随机分成试验组与空白对照组,各30例.试验组行术中残胃浆膜下及肠系膜下多点注射IL2针剂5MU,空白对照组不行此项治疗.采用流式细胞仪检测手术前后T淋巴细胞亚群的细胞活性.结果:术后3d,对照组CD4+由0.31±0.08降低为0.26±0.07,CD4+/CD8+由1.04±0.15降低为0.71±0.21,CD8+由0.29±0.07升高为0.34±0.08;试验组CD4+由0.32±0.08升高为0.39±0.08,CD4+/CD8+由1.07±0.18升高为1.74±0.24,CD8+由0.29±0.07降低为0.21±0.07(P<0.01).结论:胃癌患者机体细胞免疫功能低下,术后免疫功能仍有一段时间继续低下,术中经淋巴途径的免疫治疗可以提高机体免疫力.

AIM: To evaluate the changes and significance of cellular immune function in patients with gastric cancer who was injected IL-2 in mesentery during operation. METHODS: A total of 60 patients with gastric cancer were divided into two groups at random: the treatment group were injected 5MU IL-2 in serosa of gastric remnant and mesentery during surgery and the control group were not injected IL-2. CD4^+ and CD8^+ were detected by flow cytometry before and after operation. RESULTS: In control group, CD4^+ decreased from 0.31±0.08 to 0.26±0.07, CD4^+/CD8^+ decreased from 1.04±0.15 to 0.71±0.21 and CD8^+ increased from 0.29±0.07 to 0.34±0.08 after operation. In the treatment group, CD4^+ increased from 0.32±0.08 to (0.39±)0.08, CD4^+/CD8^+ increased from 1.07±0.18 to (1.74±)0.24 and CD8^+ decreased from 0.29±0.07 to (0.21±)0.07 after operation (P<0.01). CONCLUSION: The cellular immune function level is low in patients with gastric cancer and it tends to be lower post-operation. Immune treatment through lymph during operation may enhance the immunity.