西米替丁对大肠癌根治术后患者的免疫调节作用及临床意义

The immunoregulatory effects of cimetidine on colorectal cancer patients undergoing radical operation

目的探讨围手术期使用西米替丁对大肠癌根治术后患者全身及局部免疫的调节作用及其临床意义。方法将行大肠癌根治术的患者随机分为实验组 (n =40 )和对照组 (n =40 )。实验组术前 1周开始至术后第 14天使用西米替丁 1 2g/d ;对照组不使用西米替丁或类似药物。两组患者均于术前第 3天、术后第 7天及第 14天采血 ,检测T细胞亚群及白介素 2 (interleukin 2 ,IL 2 )、γ 干扰素 (interferon γ ,IFN γ)活性的变化 ,并于切除标本中检测肿瘤浸润淋巴细胞 (tumor infiltratinglympho cyte ,TIL)反应。结果实验组术后第 7天各项指标已恢复到术前水平。术后第 14天辅助性T细胞(CD4 ) /抑制性T细胞 (CD8)比值、IL 2及IFN γ活性比对照组及本组术前水平均有明显升高 (P <0 0 5 ) ,且TIL反应的阳性率显著高于对照组 (P <0 0 1) ,术后 3年、5年生存率较高 (P <0 0 5 )。结论西米替丁可明显减轻大肠癌患者围手术期细胞免疫抑制程度 ,缩短其术后免疫抑制周期 。

ObjectiveTo evaluate the effect of cimetidine on the immune function of colorectal cancer patients undergoing radical operation. MethodsEighty patients were randomly divided into cimetidine group ( n=40), and control group (n=40). In cimetidine group, 1.2?g of cimetidine was administered daily, beginning a week before operation for a totol of three weeks. T lymphocyte subsets, IL-2 and IFN-γ activity in patients of both groups were assayed on preoperative day 3, postoperative day 7 and 14. The lymphocyte response in the resected specimen was investigated. ResultsAll above parameters in cimetidine group resumed preoperative levels on postoperative day 7.The ratio of CD 4/CD 8, IL-2 and IFN-γ activity in cimetidine treated patients on postoperative day 14 significantly increased when compared with controls and that of before operation (P<0.05). Tumor-infiltrating lymphocytes(TIL) increased in cimetidine group (P<0.01), with higher 3 year?5 year survival rate (P<0.05).ConclusionCimetidine significantly alleviated the negative immune reaction perioperatively in colorectal cancer patients, and enhanced TIL activity benifiting a longer survival.