胃癌患者围手术期前列腺素E_2和细胞免疫功能变化的动态观察

DYNAMIC STUDY ON PERIOPERATIVE CHANGES OF PROSTAGLADIN E 2 AND CELLULAR IMMUNE FUNCTION IN PATIENTS WITH GASTRIC CANCER

采用碱性磷酸酶抗碱性磷酸酶桥联酶标法、乳酸脱氢酶释放法和放射免疫法检测了３１例胃癌患者和３０例正常对照者手术前后前列腺素Ｅ２（ＰＧＥ２）、Ｔ淋巴细胞亚群及自然杀伤细胞活性（ＮＫＣＡ）的动态变化。结果：①胃癌患者术前ＣＤ＋４／ＣＤ＋８比值较正常对照组明显降低，而ＰＧＥ２明显高于正常对照组，ＰＧＥ２与ＣＤ＋４／ＣＤ＋８比值及ＮＫＣＡ呈负相关关系；②肿瘤组织中ＰＧＥ２含量高于正常组织，切除肿瘤后外周血ＰＧＥ２下降，ＮＫＣＡ及ＣＤ＋４／ＣＤ＋８比值逐渐增高。结果提示：胃癌患者术前细胞免疫功能显著低下，处于免疫抑制状态。肿瘤组织是异常增高的ＰＧＥ２的主要来源，切除肿瘤后细胞免疫功能可逐渐恢复到正常水平。因此，手术前后连续检测ＰＧＥ２和细胞免疫功能，可评价手术疗效及监测肿瘤复发状况。

In order to investigate pre and postoperative changes of prostagladin E 2 (PGE 2) and cellular immune function in patients with gastric cancer (GC), we measured T cell subsets, natural killer cell activity (NKCA) and PGE 2 in peripheral blood (PB) of 31 GC patients and 30 controls with APAAP method, LDH release method and radioimmunoassay respectively. The results showed:① a significantly higher levels of PGE 2, and a markedly lower levels of CD + 4/CD + 8 ratio in GC patients before surgery as compared with the controls. The PGE 2 had a significant negtive coorelation with CD + 4/CD + 8 ratio and NKCA respectively.②PGE 2 in PB of GC patients gradully declined to normal levels after surgery, moreover PGE 2 in tumor tissue was markedly higher than that in normal tissue, implying that the tumor may be the major source of PGE 2 in PB. Dynamic determination of PGE 2 in PB would be great valuable in evaluation of cellular immune state, to evaluate the effect of surgery and prognosis of patients with gastric cancer.