微波固化保肢术对骨肉瘤患者Th1/Th2漂移的逆转

The Switching of Th2to Th1in Osteosarcoma Patients Treated by Limb Salvage Conjunction with Microwave Tissue Coagulation(MTC)

目的:研究微波组织固化保肢术对患者免疫功能的影响。方法:应用放射免疫分析法以及酶联免疫分析法检测20例行微波组织固化保肢术组骨肉瘤患者及20例其它手术组患者手术前后血清中IL-2、IL-4、IL-6、IL-10、IL-12的含量,应用流式细胞仪检测患者淋巴细胞亚群的变化。结果:与正常对照相比,骨肉瘤患者CD4+T细胞、血清中IL-2、IL-12减少(P<0.01),CD8+T细胞、IL-10、IL-4、IL-6含量升高(P<0.01),CD4/CD8比值降低(P<0.01〉,患者免疫功能受到抑制;术后30天截肢组及保肢组CD4+T细胞、血清中IL-2、IL-12均升高,CD8+T细胞、IL-10、IL-4、IL-6含量降低(P<0.01),CD4/CD8比值升高(P<0.01),患者免疫功能较术前改善;与截肢组比较,保肢组患者CD4+T细胞、IL-2、及CD4/CD8比值30天上升幅度明显高于截肢组(P<0.01),CD8+T细胞、IL-4、IL-630天降低幅度明显高于截肢组(P<0.01)。IL-2、IL-12与CD4+T细胞成正相关,IL-4、IL-6、IL-10与CD4+T细胞成负相关。结论:微波固化保肢术可以加速逆转骨肉瘤患者Th1/Th2向Th2漂移,增强患者的免疫功能。

Objective:To study the changes of immunological function before and after limb salvage by MTC in osteosarcoma patients.Methods:Using RIA and ELISA,serum levels of IL-2,IL-4,IL-6,IL-10,IL-12were examined in20MTC patients and20surgical patients before and after treatment.T lymphocyte subset of peripheral blood were investigated by an di -rect immunofluorescent staining method with flow cytometry.Results:The percentage of CD 4+ T cell,IL-2,IL-12and CD 4 /CD 8 ratio declined obviously(P<0.01)before treatment,on contrast,IL-4,IL-6,IL-10increased obviously.The percentage of CD 4+ T cells,IL-2,IL-12levels and CD 4 /CD 8 ratio increased(P<0.01),but a significant decrease of CD 8+ T cells,IL-4,IL-6,IL-10(P<0.01)was observed in patients treated with surgery and MTC after30days.The most dra-matic changes in the MTC patients were not only CD 4+ T cells,IL-2,and CD 4 /CD 8 ratio increased more quickly than those in the surgery group,but IL-4,IL-6and CD 8+ T cell also declined quickly(P<0.01).The correlation coefficient of cytokines and CD 4+ T cell in the same group was more than0.41(P<0.05).Conclusion:The results suggest that MTC can improve the change of cytokine pattern from Th2to Th1.