大肠癌患者手术前后T细胞及其活化抗原表达的变化与临床意义

Clinical Significance of Changes of Perioperative T Cells and Expression of Its Activated Antigen in Colorectal Cancer Patients

研究大肠癌患者围手术期的免疫状态。应用流式细胞仪检测３５例大肠癌患者手术前后Ｔ细胞表面６种抗原标志，并与良性病变患者进行对比分析。结果大肠癌患者术前ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ８、ＣＤ１６、ＣＤ６９均低于对照组，ＣＤ８高于对照组（Ｐ＜０．０５），ＣＤ３＋／ＨＬＡ－ＤＲ＋与对照组相同；术后ＣＤ８降低，ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ８、ＣＤ１６、ＣＤ６９、ＣＤ３＋／ＨＬＡ－ＤＲ＋均升高（Ｐ＜０．０５），活化Ｔ细胞ＣＤ３＋／ＨＬＡ－ＤＲ＋明显高于对照组（Ｐ＜０．０１）。大肠癌患者术前免疫功能低下，术后活化Ｔ细胞明显增多，切除肿瘤有益于改善患者细胞免疫功能，故减瘤手术是必要的。

To evaluate the perioperative immunologic status of patients with colorectal cancer, six kinds of surface antigens of T lymphocytes were measured using flow cytometry in 35 cases before and after operation. The data were compared with those in the controls with benign diseases. Before operation, CD 3, CD 4, CD 4/CD 8, CD 16 , CD 69 were significantly lower in cancer patients than those in control, and CD 8 was much higher in cancer patients ( P <0.05) while CD 3+/HLA DR+ didn't show significant difference between the cancer patients and the controls. Postoperatively, CD 3, CD 4, CD 4/CD 8, CD 16 , CD 69 and CD 3+/HLA DR+ increased significantly ( P <0.05), but CD 8 decreased in cancer patients. The activated T lymphocytes CD 3+/HLA DR+ were much higher in cancer patients than those in controls ( P <0.01). The immunity of colorectal cancer patients were suppressed before operation, but the increase of activated T lymphocytes after operation suggests that removal of tumor might be helpful in enhancing the cellular immunity of the cancer patients.