化疗对妇科恶性肿瘤患者细胞免疫功能的影响

Effect of chemotherapy on cell immune function in patients with gynecologic malignant tumours

目的 探讨化疗对妇科肿瘤患者免疫功能的影响。方法 采用流式细胞仪检测 30例妇科恶性肿瘤患者化疗前后周围血NK细胞活性及淋巴细胞亚群CD3,CD4 和CD8,并以 30例体检者做对照。结果 ①NK细胞活性和淋巴细胞亚群CD3,CD4 比率及CD4 /CD8比值 :恶性肿瘤患者较正常对照组低 (P <0 0 5 ) ;化疗后全身化疗者低于介入化疗者 ;最初 3次化疗较以后化疗高 ;血白细胞小于 4× 10 9/L时较大于 4× 10 9/L时低 ;出现较严重的胃肠道反应及肝功能损害时低于肝功能正常及轻度胃肠道反应时 (P <0 0 5 )。②CD8值 :只有当血白细胞小于 1× 10 9/L时 ,CD8才下降 (P <0 0 5 ) ,其他情况CD8无变化 (P >0 0 5 )。结论 化疗对患者免疫功能会产生影响 ,普通剂量初期可刺激免疫功能 ,较长期化疗或当化疗引起较严重副作用时会对机体免疫功能产生损害作用。粒细胞集落刺激因子使血白细胞回升的同时促进免疫功能的恢复 。

Objective To study the effect of chemotherapy on cell immune function in patients with gynecologic malignant tumours. Methods Natural killer cell activity, lymphocyte subsets of CD 3, CD 4 and CD 8 in 30 patients with gynecologic malignant tumours and 30 normal controls were measured with flowcytometry before and after chemotherapy. Results ① Natural killer cell activity and lymphocyte subsets of CD 3, CD 4 and CD 4/CD 8 were lower in patients with malignant tumours than in normal controls ( P<0.05 ). After chemotherapy these values were lower than that before chemotherapy, were lower in patients treated with intravenous chemotherapy than transcather intraarterial perfusion, were higher during first three chemotherapy, and were lower when peripheral blood white cell drop-ped below 4×10 9/L, and when severe side effects appeared ( P<0.05 ). ②CD 8 remained unchanged after chemotherapy unless peripheral blood white cell drop below 1×10 9/L ( P>0.05 ). Conclusion Chemotherapy, affects immune function. It initially stimulates immune function, but long-term or strong chemotherapy with severe side effects will impair immune function. GSF may help patient regain immune function. Transcather intra-arterial perfusion chemotherapy hag smaller impact on immune function than infravenous chemotherapy.