高聚金葡素联合化学药物治疗口腔癌的疗效与免疫功能观察

SIGNIFICATION OF PERIPHERAL BLOOD IMMUNE CHANGES IN TREATMENT FOR ORAL CANCER WITH (HAS) AND CHEMOTHERAPY

目的 评价高聚金葡素 (HAS)联合化疗治疗口腔癌的疗效 ,以及免疫治疗在肿瘤化疗中的应用价值 ,着重从机体免疫状况以及细胞因子的调控方面 ,探讨其作用机理。方法 对 2 6例口腔癌进行颞浅动脉逆行插管术 ,分别进行化疗和 HAS联合化疗两种方式。观察疗效和药物毒副作用 ,并采用流式细胞技术、EL ISA法等测定其免疫状态。结果 治疗组总有效率为 80 % (8/ 10 ) ,无明显毒副作用 ,并减轻化疗所致的毒副作用。口腔癌患者细胞免疫受到不同程度地抑制 ,而体液免疫功能处于正常范围内 ,CIC值的升高与肿瘤免疫抑制相关。观察两组治疗前后免疫学指标 ,发现 HAS可刺激 T- CD+4 细胞增殖 ,并能分泌大量细胞因子如 IL - 2 ,进一步促进细胞免疫应答。化疗对免疫功能有明显的抑制作用 ,而经 HAS治疗后 CD4、CD4/ CD8比值、IL - 2升高较化疗组明显 (P<0 .0 5 )。所以使用 HAS可避免因化疗和手术等所致的术后早期免疫功能下降。但 HAS治疗组术后第二个月免疫功能受到抑制 ,与超抗原所致的免疫耐受有关。结论 高聚金葡素联合化疗疗效显著 ,可减少化疗所致的毒副作用。HAS主要通过刺激 T细胞增殖 ,调节细胞因子的分泌 ,达到增强免疫功能和抗癌目的 。

Objective To evaluate treatment affects and signification of serum immune changes in treatment effects of HAS and chemotherapy in 26 cases with oral cancer. Methods HAS and chemotherapy drugs were injected into tumor by reversed insertion of superficial temporaries arterial. T cell subsets, NK cell, IL 2, sIL 2R, IgA, IgM, IgG, IgE and CICs in peripheral blood were analyzed by FCM, ELISA et al methods. Results The immune conditions of oral cancer were in disorder, especially the cellular immunity. Efficient rate that was higher than the control was 80% in the group of HAS and chemotherapy drugs. The immunity conditions had some suppression after chemotherapy. But the level of serum CD 4, CD 4/CD 8, IL 2 and sIL 2R were elevated in the group of HAS ( P <0.05). As a result, the function of immunity was restored by HAS. Conclusion The results suggested that the combination of HAS and chemotherapy could be used as efficient method for patients with oral cancer. The function of HAS was mediated by the stimulation of cellular immunity and regulation of secretion of cellular factors, such as IL 2.