微波组织固化保肢术对恶性骨肿瘤患者淋巴细胞亚群的影响

Effect of limb salvage of malignant bone tumors in conjunction with microwave tissue coagulation on T-cell subset

研究微波组织固化保肢术对患者免疫功能的影响．方法：通过直接免疫荧光法，用流式细胞术观察了52例行微波组织固化保肢术的恶性骨肿瘤患者，44例截肢患者手术前后淋巴细胞亚群的变化．结果：与正常对照相比，恶性骨肿瘤患者CD4降低，CD8升高，CD4／CD8降低（P＜0．01），患者免疫功能受到抑制；术后30d截肢组及保肢组CD4均升高，CD8降低，CD4／CD8比值升高（P＜0．01），患者免疫功能较术前改善；与截肢组比较，保肢组患者CD4及CD4／CD8升高早，30d上升幅度明显高于截肢组（P＜0．01），180d恢复正常；术后复发及转移患者CD4均再次降低，CD8升高，CD4／CD8降低（P＜0．01），且在连续观察的患者早于临床指征出现改变．结论：微波组织固化保肢术可有效地提高机体免疫功能，淋巴细胞亚群是病情监测的良好指标．

To observe the effects of limb salvage with microwave tissue coagulation(MTC) on immune function of patients with malignant bone tumor. Methods: T lymphocyte subsets of peripheral blood in 52 malignancy with microwave tissue coagulation, 44 malignancy with amputation were investigated by a direct immunofluorescent staining method with flow cytometry. Results: In patients with bone malignancy, the percentage of CD4+ cell and CD4/CD8 ratio declined obviously (P＜0. 01). There were increase of percentage in CD4+cell and CD4/CD8 ratio, and a significant decrease of percentage in CD8 cell in the patients treated with amputation and microwave thiamin after 30 days. The most dramatic change in the mass with MTC was CD4 and CD4/CD8 ratio increased more quickly than in the mass with amputation (P＜0.01). Further studies showed immune function of MTC patients returned to normal after 180 days. The remarked change were the consistent decrease in CD4/CD8 ratio, a relative increase in CD8+ cell with a concomitant decrease in CD4+ cell, while the disease was recurrent or metastasis before the clinic changes. Conclusion: MTC can improve the immune function of the patients, T cell subset is quiet beneficial to the direction of the disease.