腹腔化疗对老年结直肠癌病人手术后细胞免疫功能的影响

Effect of Intraperitoneal Chemotherapy on Immune Function in Elderly Patients with Colorectal Cancer After Radical Operation

目的:探讨老年结直肠癌病人手术后腹腔化疗对免疫状况的影响。方法:对1998年1月至2 0 0 2年12月6 0岁以上行根治性手术的5 2例结直肠癌病人进行腹腔化疗前后细胞免疫检测,并将之与我院同期健康老年对照组和行静脉化疗病例进行比较。所有病人于化疗前1d和化疗后1周早晨空腹时静脉采血,测定血清中NK细胞和T细胞亚群。结果:老年结直肠癌病人手术后CD4 + 和NK细胞水平明显低于健康老年人群;老年结直肠癌病人化疗后CD4 + 、CD4 + /CD8+ 和NK细胞水平低于化疗前,其中静脉化疗病人化疗后较化疗前明显降低,存在统计学意义(P <0 .0 5 ) ;而腹腔化疗组病人化疗前后上述指标的变化不大,无统计学意义(P >0 .0 5 )。结论:针对老年病人的免疫特点,采用细胞免疫抑制较轻的腹腔化疗方式进行化疗,对老年结直肠癌病人有一定的临床价值。

Objective： To investigate the effect of intraperitoneal chemotherapy on immune function in elderly patients with colorectal cancer after radical operation. Methods：From Jan. 1998 to Dec. 2002, NK cell and T cell subgroup of 52 elderly patients with colorectal cancer were measured 1 day before and 7 days after intraperitoneal chemotherapy. The results were analyzed with those of normal old people and those of intravenous chemotherapy. Results： The levels of CD4^＋,CD4^＋/CD8^＋and NK cell were lower in elderly patients with colorectal cancer than those of the normal old people. The levels of CD4^＋ ,CD4^＋/CD8^＋ and NK cell decreased in elderly patients with colorectal cancer after intravenous chemotherapy and had no distinct change after intraperitoneal chemotherapy. Conclusion：It is essential to treat elderly patients with colorectal cancer after operation with intraperitoneal chemotherapy, which has less cellular immune damage.