手术及化疗对胃癌患者免疫功能的影响

Effect of operation and chemotherapy on the immunological function of patients with gastric cancer

测定５０例胃癌患者手术前后和化疗前后自然杀伤（ＮＫ）细胞活性和Ｔ细胞亚群，以了解胃癌患者术前免疫状态及手术和化疗对其的影响。结果显示：术前胃癌患者免疫功能随着病情进展呈进行性下降，但与肿瘤类型无直接关系。提示胃癌患者免疫抑制是肿瘤源性的。因此肿瘤组织切除手术，不论是根治性切除还是姑息性切除，术后外周血ＮＫ细胞活性、ＣＤ４＋细胞和ＣＤ４＋／ＣＤ８＋细胞比值均较术前明显增加（Ｐ＜０．０５），而代表免疫抑制ＣＤ８＋细胞较术前明显下降。这些结果提示，对于胃癌患者应力求行根治性切除，即使晚期病人，亦应力争手术切除，最大限度地去除和减少肿瘤负荷及其产生的免疫抑制因子。本结果还显示，化疗对患者免疫功能有损害作用。

in this experiment,we studied the immune state and effects of different operations and chemotherapy on the immunological function of the patients with gastric cancer by measuring the activity of NK cells and T-lymphocyte subsets before and after operation and chemotherapy in 50 cases.The results showed that the immunological function of the patients with gastric cancer decreased progressively with the deterioration of disease before operation.However,there was no direct correlation between the degree of malignance and the pre-operative immunological function,indicating that the suppression of immune state originated from the tumor.Our data showed that the activity of circulatory NK cells,CD_4￣+cells,CD_4￣+/CD_8￣+ cells ratio increased significantly postoperation,while CD_8￣+ cells which represents the immunosuppression decreased significantly.These results suggest the tumour tissue should be removed as completely as possible,even in advanced patients,to remove or reduce tumour load and immunosuppression as large as possible.Our findings also shows that chemotherapy can induce harmful effect to immunological function of tumour patients.