口腔癌患者手术前后细胞免疫功能的变化

The changes of cell immune function in patients with oral cancer before and after operation

目的探讨口腔癌患者手术前后细胞免疫功能变化的临床意义。方法将20例健康志愿者（对照组）及经手术后病理证实口腔鳞癌患者（观察组）20例纳入研究，检测口腔癌患者术前、术后外周血T淋巴细胞各亚群和Th1细胞分泌的细胞因子水平。结果与对照组相比，观察组术前血CD3＋、CD4＋、CD8＋、CD5＋T淋巴细胞比例和CD4／CD8比值均明显下降（t=7．908、7．282、2．428、4．360、4．329，均P〈0．05），观察组术后血CD3＋、CD4＋、CD8＋、CD5＋T淋巴细胞比例和CD4／CD8比值较术前均有明显改善（t=3．994、6．159、2．401、2．446、2．102，均P〈0．05），但CD4＋T淋巴细胞和CD4／CD8比值仍然明显低于对照组（t=2．741、3．133，均P〈0．05）。观察组术前T淋巴细胞分泌的细胞因子水平均较对照组明显下降（t=3．175、2．747、43．000、3．137、16．160、46．750，均P〈0．05），观察组术后T淋巴细胞分泌的细胞因子水平较术前均有改善。结论口腔癌患者较健康人存在着免疫抑制现象，主要变现为辅助性T细胞显著减少，而抑制性T细胞明显增加，CD4／CD8比值下降；经手术治疗后患者免疫功能得到明显的改善。

Objective To explore the clinical significance of changes of cell immune function in patients with oral cancer before and after operation. Methods 20 healthy volunteers （ control group） and 20 patients with oral squamous cell carcinoma who pathologically confirmed after operation （observation group） were included in this study. The peripheral blood T lymphocyte subsets and the levels of cytokines in Thl cells were detected before and after surgery. Results Compared with the control group, the percentage of preoperative serum CD3＋ , CD4＋, CD8＋, CD5＋ T lymphocyte and CD4/CD8 ratio in the observation group were decreased significantly （ t = 7. 908,7. 282,2. 428, 4. 360,4. 329,P 〈 0. 05 ）. In the observation group, the percentage of CD3＋ , CD4＋ , CD8 , CD8＋ T lymphocyte and CD4/ CDs ratio after operation were significantly improved than before surgery （t = 3. 994,6. 159,2. 401,2. 446,2. 102, all P 〈 0. 05 ）, but CD4 T lymphocytes and the ratio of CD4/CD8 were still significantly lower than the control group（ t = 2. 741,3. 133, all P 〈 0.05 ）. In the observation group, the preoperative levels of cytokines secreted by T lymphocytes were significantly lower than those in the control group （t = 3. 175,2. 747,43.000,3. 137,16. 160,46. 750, all P 〈 0.05 ）.After operation, the levels of cytokines secreted by T lymphocytes were improved. Conclusion Patients with oral cancer have immune suppression, which manifest with the decrease of Th cells, the increase of suppressor T cells and the decrease of CDJCDs ratio. The immune function of the patients is improved after operation.