胃癌患者围手术期外周血T细胞亚群及血清sIL-2R水平

Levels of peripheral blood T subgroups and serum sIL-2R in perioperation period in patients with gastric cancer

目的通过对外周血T细胞亚群及血清可溶性白介素-2受体(sIL-2R)水平的检测和分析,评价胃癌患者围手术期的免疫功能。方法80例接受标准肿瘤根治术的胃癌患者,分别于入院后第2天(术前)和术后第7天和第21天,经流式细胞术检测外周血T细胞亚群,包括CD3^+、CD4^+细胞数量及CD4^+/CD8^+细胞比值(CD3^+、CD4^+、CD4^+/CD8^+);采用酶联免疫吸附法测定血清sIL-2R水平,以30名同期健康体检者作为正常对照(对照组)。分析胃癌患者T淋巴细胞亚群及血清sIL-2R水平与肿瘤的组织学类型、分化程度和临床分期的关系。结果与同期对照组相比,术前胃癌组外周血CD3^+、CD4^+、CD4^+/CD8^+明显降低(P<0.05),血清sIL-2R水平则显著增高(P<0.05);Ⅲ、Ⅳ期胃癌患者较Ⅰ、Ⅱ期的改变更为显著(P<0.05)。与术前比较,术后第7天胃癌组患者外周血CD3^+、CD4^+、CD4^+/CD8^+显著降低(P<0.05),而血清sIL-2R水平明显升高(P<0.05),至术后21 d逐步恢复至术前水平,但与对照组比较差异仍有统计学意义(P<0.05)。结论胃癌患者围手术期免疫功能低下,Ⅲ、Ⅳ期患者尤为明显。外科手术在治疗肿瘤的同时也抑制了患者的免疫功能。

Objective To evaluate the immune function in perioperation period in patients with gastric cancer by detection and analysis of levels of peripheral blood T subgroups and serum soluble interleukin-2 receptor （sIL-2R）. Methods Eighty patients with gastric cancer who received standard radical treatment were enrolled. The levels of peripheral blood T subgroups, including concentrations of CD3 ^＋ , CD4^＋and ratio of CD4 ^＋/CD8^＋ on d 2 after hospitalization（pre-operation） , d 7 and d 21 post-operation were detected by flow cytometry. The levels of serum sIL-2R were examined by ELISA. Besides, 30 heahy subjects were served as control group. The correlation of the levels of T subgroups and serum sIL-2R with histological type, differentiation and clinical staging was analysed. Results Compared with control group, the levels of CD3^＋ ,CD4 ^＋ and CD4 ^＋/CD8 ^＋ significantly decreased （ P 〈 0.05 ） , while those of slL-2R significantly increased （ P 〈 0.05）. There were significantly differences between those with gastic cancer of III and IV stage and those with I and II stage （ P 〈0.05）. Compared with those pre-operation, the levels of CD3 ^＋ ,CD4^＋ and CD4^＋/CD8 ^＋on d 7 significantly decreased in patients with gastric cancer（P 〈 0.05） , while those of sIL-2R significantly increased（P 〈 0.05）. The levels gradually recovered to pre-operative ones on d 21 （P 〈 0.05 ）, but were still significantly different from those in control group（ P 〈 0.05）. Conclusion The immune function of patients with gastric cancer in perioperation period was lower, especially for those with gastric cancer of Ⅲ and Ⅳ stage. Surgical intervention may contribute to the post-operative immunosuppression.