结肠癌术后化疗对外周血免疫细胞比例及凋亡的影响

Study on the Effects of Radical Resection and Chemotherapy on Immunocytes in Peripheral Blood with Colon Cancer

目的研究结肠癌术后化疗患者外周血免疫细胞亚群变化特点、淋巴细胞凋亡状况及其意义。方法应用流式细胞术对40例结肠癌患者手术前后(术前1d、术后3d、化疗前1d)、化疗过程(化疗第3d、化疗后3d)中外周血T淋巴细胞亚群及NK细胞水平进行检测,以AnnexinV/PI双标流式细胞术对淋巴细胞凋亡、坏死状况进行检测。结果结肠癌根治术后3d,患者外周血T淋巴细胞及NK细胞数量较术前有所减少,但无显著差异(P>0.05)。至化疗前1d,患者外周血CD3+,CD4+T细胞及NK细胞数量较术前显著增高(P<0.01),但CD8+T细胞数量减少(P<0.05)。化疗3d后,患者外周血CD3+,CD4+,CD8+T细胞及NK细胞水平较术前全面下降(P<0.05),但CD4+/CD8+比例变化不大,而淋巴细胞凋亡坏死比例明显升高。至化疗结束后3天,T淋巴细胞各亚群及NK细胞数量开始逐渐回升。结论结肠癌根治术手术本身对患者外周血淋巴细胞及NK细胞影响不大,术后患者免疫细胞水平明显升高,机体免疫状况明显改善。化疗可造成患者机体的一过性免疫抑制,可能与其造成机体淋巴细胞的凋亡坏死有关。

Objective To investigate the alterations of T lymphocytes＇subsets, NK cells and their apoptotic rates in colon cancer patients who received radical resection and chemotherapy. Methods The alterations of T lymphocytes subsets and NK ceils were investigated respectively in 40 cases of colon cancer at 1 day before and 3 days after radical resection, 1 day before, 3rd day during, and 3 days after chemotherapy by method of Flow Cytometry. At the same time, the apoptotic rates of the immunocyte were investigated by Flow Cytometry. Results Compared with the level of preoperation： The T lymphocytes and NK cells decreased three days after the operation, but no significant difference showed （P 〉 0.05 ）. The amounts of CD3 ＋, CD4 ＋ T cells and NK ceils were significantly increased at one day before the chemotherapy （P 〈0.01 ）. On the third day of the chemotherapy, the amounts of the CD3 ＋, CD4 ＋, CD8 ＋ T cells and NK cell decreased significantly （P 〈 0.05 ）, but the rations of CD4 ＋/CD8 ＋ T cells did not changed much, the apoptotic rates of immunocyte increase significantly. Three days after the chemotherapy the amounts of T lymphocytes and the NK cells increased gradually. Conclusions The radical resection had no significant influences on immunocytes of colon cancer cases, and anti-tumor immune levels of the patients were increased after the operation. Chemotherapy could inhibit immune levels of the patients, which might be caused by the apoptosis of immune cells.