微波原位热疗保肢手术后机体免疫功能的变化

The Effects of Tumor Resection and Intraoperative Microwave Heating on Immune System in Bone Tumor

为探讨局部热疗对机体免疫功能的影响，我们检测了１０例骨肉瘤患者在接受局部肿瘤切除加微波热疗保肢手术后Ｔ淋巴细胞免疫功能的变化。结果表明本组患者术前外周血中的ＣＤ３比例比正常值下降了４２％左右，以ＣＤ４减少为主，ＣＤ４／ＣＤ８比值低下，ＰＨＡ皮肤试验为阴性，免疫系统处于抑制状态。术后１周ＣＤ３的比例即已显著增加，接近术前的２倍，以ＣＤ４增加为主，ＣＤ４／ＣＤ８比值从术前的１．０４增加到２．８６～２．９３，至术后第３周Ｔ淋巴细胞亚群仍在正常范围内，ＰＨＡ皮肤试验表现为强阳性。而对照组虽然也将肿瘤组织切除，Ｔ淋巴细胞亚群及ＰＨＡ皮肤试验却无明显恢复，且有进一步恶化的表现，可能与手术创伤介导的免疫抑制有关。证明微波原位热疗术可以增强机体的免疫力，这将对骨肿瘤的预后产生积极的影响。

Objective: To determine the efficacy of microwave heating on host immunity. Methods:Ten patients with osteosarcoma were treatred with tumor resection and intraoperative microwave heating on tumor bone in site at 50 °C for 15 minutes. The T cell immunity of the patients was investigated pre and postoperattively. Results: The immune response of the patients were supressed before operation and the proportions of T lympjocytes subset changed immediataly after operation. CD 3 increased as two times as preoperation. CD 4 raised more obviously than CD 8 did. The ratio of CD 4/CD 8 was insreased from 1.04 to 2.94. The skin respose to mitogen PHA showed strong positiove postoperatively. Conclusion: The intraoperative miocrowave heating could improve the immunological function of the patients,and enhance the results.