骨肿瘤、骨转移癌患者免疫功能变化及临床意义

ImmuneFunctionsinPatientswithBoneTumorandMetastasisanditsClinicalSignificance

对６２例骨肿瘤、骨转移癌患者外周血中Ｔ淋巴细胞亚群（ＰＴＬＳ）、淋巴细胞转化率（ＬＴＲ）的变化进行研究。结果显示：骨肿瘤患者外周血中全Ｔ淋巴细胞（ＣＤ３＋）及辅助／诱导性Ｔ细胞（ＣＤ４＋）较对照组明显降低，抑制／细胞毒性Ｔ细胞（ＣＤ８＋）无明显变化，ＣＤ４＋／ＣＤ８＋比率显著下降，以恶性骨肿瘤组降低最明显。骨转移癌患者呈类似变化。淋巴细胞转化率，骨肿瘤、骨转移癌组显著低于正常组。证明患者的免疫功能变化与骨肿瘤的存在、发展密切相关。此外，观察了恶性骨肿瘤患者手术前后ＰＴＬＳ变化，术后ＣＤ３＋、ＣＤ４＋、ＣＤ８＋恢复正常水平，ＣＤ４＋／ＣＤ８＋比率升高。随访观察结果亦表明ＬＴＲ、ＣＤ３＋、ＣＤ４＋持续降低，ＣＤ４＋／ＣＤ８＋比率倒置的患者预后较差。提示动态观察恶性骨肿瘤患者外周血中Ｔ淋巴细胞及其亚群、淋巴细胞转化率的变化有助于判断预后。

PeripheralbloodTlymphocytessubsets(PTLS)andlymphocytetransformationrate(LTR)werequantitatedin62patientswithbonetumorsandbonemetastases.Thetotalnumberoflym-phocytes(CD3+)andThelpercels(CD4+)decreasedsignificantly.Tsuppressorcels/kilercels(CD8+)didnotshowanydiferencebetweenthetestedgroups.TheratioofCD4+/CD8+wassignificantlyde-creasedinthebonetumorgroups,butlowerinthegroupwithmalignanttumors.LTRwaspoortoo.Theabovechangeswerealsoseeninthegroupwithmetastasis.Itissuggestedthatthechangesofim-munefunctionofthepatientswererelatedtotheprogressivegrowthofthebonetumors.Thetestsfortheirchangeswerehelpfulinthejudgementoftheprognosisofpatientswithmalignantbonetumors.