肺癌患者红细胞免疫功能改变及其影响因素

A Clinical Research on Immune Function of Erythrocytes in the Patients with Lung Cancer

目的:探讨肺癌患者红细胞免疫功能状态及手术治疗对红细胞免疫功能的影响。方法:选择60例经纤支镜检查病理证实为肺癌而未手术的肺癌患者以及25例经手术切除病理证实为肺癌患者行红细胞免疫功能检测、35名健康志愿者为对照。比较患者手术组、未手术组与对照组RBC免疫功能;且患者组以TNM分期、围术期分层比较。结果:手术组与未手术组相比,前者RBCC3b受体花环率、自然肿瘤RBC花环试验(NTER)显著高于后者(P<0.01),但仍低于对照组(P<0.05),RBCC3b受体花环促进率(RFER)、患者肿瘤RBC花环,如直向肿瘤RBC花环率(DTER)、促肿瘤RBC花环率(ETER)、协同肿瘤RBC花环率(ATER)均高于后者(P<0.05),与正常对照无差异(P>0.05);RBCC3b受体花环抑制率(RFIR)低于后者(P<0.01),但仍高于对照组(P<0.05)。结论:肺癌患者RBC免疫功能低下,机体红细胞免疫功能状态与肿瘤组织负荷密切相关;手术可加剧这种改变。

Objective. To study the immune function of erythrocytes and the influence of surgical treatment on it in the patients with lung cancer. Methods： A total of 85 patients with lung cancer were studied, consisting of 60 non-operation patients and 25 postoperative patients. Their immune function of erythrocytes was analyzed and compared with 35 healthy people. The tests included RBC C3b receptor rosette （RBC C3b rr）, RBC immune complex rosette （RBC ICR）, natural tumor erythrocyte rosette （NTER）, direct tumor erythrocyte rosette （DTER）, associated tumor erythrocyte rosette （ATER）, enhanced tumor erythrocyte rosette （ETER）, RBCC3b immune adherence enhance factor （RFER） and RBCC3b immune adherence inhibitor factor rosette （RFIR）. Resets： In the post-operative group, the values of RBC C3bRRT and NTER were significant higher than those of non-operation group respectively （all P 〈0.01）, but still lower than those of normal control group respectively （all P〈0.05） ; RFER, DTER, ETER and ATER were higher than those of non-operation group respectively （all P〈 0.01）, but without significantly different from normal control group（P〉0. 05）; RBCICR and RFIR were lower than those of non-operation group（all P〈0. 01）. Conclusion： RBC immunity functions were suppressed in the cases of lung cancer, and it may be related to body tumor load of the patients. Surgery can enhance the disturbances of immune system.