腹腔化疗对老年进展期胃癌患者术后细胞免疫的影响

Effect of intraperitoneal chemotherapy on immune function in elderly patients with gastric cancer after radical operation

目的探讨老年胃癌患者手术后腹腔化疗对免疫功能的影响。方法对我院1997年1月至2002年12月60岁及以上接受胃癌根治性手术并进行腹腔化疗的49例患者前后细胞免疫检测,并与我院同期接受胃癌根治性手术并单独行静脉化疗的37例患者进行比较,以健康老年人作为正常对照组。所有患者于化疗前1d和化疗后7d早晨空腹时静脉采血,正常对照组于体检当日早晨空腹时静脉采血,测定血清中NK细胞和T细胞亚群。结果老年胃癌患者手术后CD4+和NK细胞水平明显低于正常对照组;老年胃癌患者化疗后CD4+、CD4+/CD8+和NK细胞水平低于化疗前,静脉化疗组化疗前后的差异具有统计学意义(P<0.05),而腹腔化疗组病人化疗前后的差异无统计学意义(P>0.05)。结论针对老年胃癌患者手术后的免疫特性,宜采用对细胞免疫抑制较轻的腹腔化疗方式进行化疗。

Objective To investigate the effect of intraperitoneal chemotherapy on immune function in elderly patients with gastric cancer after radical operation. Methods From Jan. 1997 to Dec. 2002, NK cell and T cell subgroup of 49 elderly patients with gastric 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 patients. Results The levels of CD4^＋, CD4^＋/ CD8^＋ and NK cell were lower in elderly patients with gastric cancer than those of the normal old people. The levels of CD4^＋, CD4^＋/CD8^＋ and NK cell decreased in elderly patients with gastric cancer after each intravenous ehemotherapy （P〈0.05） and had no distinct change after each intraperitoneal chemotherapy （P〉0.05）. Conclusions It is essential to treat elderly patients with gastric cancer after operation with intraperitoneal chemotherapy, which has less cellular immune damage.