胃癌手术前后T细胞亚群、Ts功能变化及意义

Alterations and Their Significances of T Lymphocytes Subsets,Ts Function in Preoperation and Postoperation of Patients with Gastric Cancer

目的 研究胃癌切除前后 T细胞亚群数量和功能两方面的变化 ,并就其变化与术后感染的关系进行探讨。方法 分别用3H- Td R渗入法和单个核细胞直接免疫荧光法检测 38例胃癌患者 Ts功能和 T细胞亚群水平 ,并对手术切除后不同时间点进行了对比。结果 胃癌患者无论手术前后 Ts功能明显高于正常人 (P<0 .0 1) ,而其本身在肿瘤切除前后差异无显著意义 (P>0 .0 5 ) ;胃癌术前 CD4 / CD8明显降低 (P<0 .0 0 1) ;术后 CD4 先降后升 ,CD8则轻度增高 ,CD4 / CD8在术后 9～ 12 d恢复到术前水平 ;术后 2～ 3d,CD4 下降的感染率为 4 3.5 % ,CD4 增高的感染率为 13.3%。结论 胃癌患者的细胞免疫功能明显低下 ,手术切除肿瘤有利于其功能的恢复 ,但同时手术创伤亦可引起一定程度的免疫抑制 。

Objective To evaluate alterations of num ber and function of T lymphocytes subsets preoperationally and postoperationally in patients with g astric cancer.Method Ts function and T lymphocytes subsets leve ls were detected respectively by 3H-TdR and direct immunofluorescence technique in 3 8 patients with gastric cancer.And the results of different time points were com pared with.Results Ts function of patients with gastric cnacer, whether preopera tion or postoperation,was remarkable higher than that of the normal(P<0.01),however,no significant difference was seen between the preoperation and postoperation(P>0.05). CD 4/CD 8 was significant depress ed (P<0.001) in the preoperation.After surgical removal of tum or,CD 4 was depressed at beginning of postope ration,followed increased,and CD 8 level increased slightly,CD 4/CD 8 was res tored to the level of preopera tion in 9～12 days postoperatively.The study on association between postoperativ e infection and variation of CD 4 showed that the rate of infection was 43.5% i n the patients with CD 4 depression and 13.3% in CD 4 increassion in 2～3 days postoperatively.Conclusion The cellular immunity was significa nt lower in pati ents with gastric cancer.The surgical removal of tumor was favourable for restor ation of the immune function,but the surgical lesion could result in some degre e of immune suppression,and it was positive correlation with postoperative infection.