支气管动脉灌注化疗对肺癌患者血清SIL-2R及T细胞亚群的影响

Effect of bronchial artery infusion chemotherapy on serum interleukin-2 receptor and T lymphocytes subsets in patients with lung cancer

目的探讨肺癌患者支气管动脉灌注化疗前后血清可溶性白细胞介素2受体(SIL-2R)、T细胞亚群的变化及临床意义。方法选择肺癌患者30例,于支气管动脉灌注(BAI)化疗前、化疗后2周、4周,分别采用双抗体夹心(ELISA)法及碱性磷酸酶-抗碱性磷酸酶(APAAP)法检测血清SIL-2R、T细胞亚群的变化,并与30例健康者作对比分析。结果肺癌患者SIL-2R水平、CD8细胞显著高于健康者,同时CD3细胞、CD4细胞、CD4/CD8比值低于健康对照组。按TNM分期,Ⅲ期患者SIL-2R水平高于Ⅱ期(P<0.01),Ⅳ期高于Ⅲ期(P<0.05)。BAI治疗后2周血清SIL-2R水平、T细胞亚群与治疗前比较未见明显变化(P<0.01),治疗后4周血清SIL-2R、CD3、CD4、CD4/CD8比值升高,CD8下降(P<0.01)。结论动态观察肺癌患者BAI治疗前后血清SIL-2R水平、T细胞亚群变化可监测机体的免疫状况,有助于判断病情及预后,指导临床综合治疗;对首次接受BAI治疗的患者在4周后进行第二次治疗较为恰当。

Objective To study the changes of the serum levels of soluble interleukin-2 receptor （SIL-2R） and T lymphocytes subsets in patients with lung cancer before and after bronchial artery infusion chemotherapy（BAI） and evaluate their clinical significance. Methods Thirty cases of lung cancer patients were enrolled in the study. ELISA technique and APAAP technique were used to measure the serum levels of SIL-2R and T lymphocyte subsets in peripheral blood respectively before BAI,two weeks after BAI and four weeks after BAI and their values were compared with those of 30 healthy, controls. Results The findings showed that the serum levels of SIL-2R and percentage of T-suppressor cells（ CD8 ） in patients were significandy higher than those in healthy controls. However, percentage of total T cells （ CD3 ）, T-helper cells （CD4） and ratio of CD4/CD8 in patients were remarkably lower than those in healthy controls （P 〈 0.01 ）. According to the TNM classification, SIL-2R level in stage Ⅱ was lower than that in stage Ⅲ （P 〈 0.01 ）, and it was higher in stage IV than in stage Ⅲ （ P 〈 0.05 ）. At two weeks after BAI, the serum levels of SIL- 2R and T lymphocyte subsets had no significant changes （P 〉 0.05 ）, but the serum levels of SIL-2R and percentage of CD8 significantly decreased, the percentage of CD3, CD4 and ratio of CD4/CD8 increased at four weeks after BAI. Conclusions Consecutive observation of serum SIL-2R level and T lymphocyte subsets is helpful to judging the immune state before and after BAI, to evaluating the state of disease and prognosis, and to directing therapy. It is reasonable that lung cancer patients receive the second BAI at four weeks after the first management.