外科治疗对胃癌患者抗肿瘤免疫功能的影响

Effect of surgical treatment on anti-tumor immune function in patients with gastric cancer

目的:探讨外科治疗对胃癌患者抗肿瘤免疫功能的影响。方法:选取2015年4月~2016年4月河北省第七医院收治的50例胃癌患者为观察组,同期健康体检者50例为对照组,采集观察组术前、术后7 d及对照组清晨空腹静脉血,采用流式细胞仪检测外周血T细胞亚群水平,分析手术前、术后7 d及术前不同病理分期机体免疫功能状态。结果:观察组CD3^+、CD4^+、CD4^+/CD8^+、NK细胞水平较对照组明显下降,CD8^+较对照组明显升高(P<0.05);术前CD3^+、CD4^+、CD4^+/CD8^+、NK细胞表达水平低于术后7 d,CD8^+高于术后7d,差异有统计学意义(P<0.05);病理分期为Ⅰ、Ⅱ期患者外周血CD3^+、CD4^+、CD4^+/CD8^+、NK细胞水平较病理分期为Ⅲ、Ⅳ期患者明显升高,CD8^+低于Ⅲ、Ⅳ期,差异有统计学意义(P<0.05)。结论:临床对胃癌患者外周血T细胞亚群及NK细胞的表达水平进行检测,可作为评价患者免疫功能状态的重要指标,对病情的判断及预后评估有重要意义。

Objective： To explore the effect of surgical treatment on the anti-tumor immune function in patients with gastric cancer. Methods： A total of 50 patients with gastric cancer who were admitted in our hospital from April,2015 to April,2016 were included in the study and served as the observation group,while 50 healthy individuals who came for physical examinations were served as the control group. The morning fasting venous blood before operation and 7 d after operation in the observation group and in the control group was collected. FCM was used to detect the levels0 The immunological function status at different pathological stages before operation and 7 d after operation was analyzed. Results： The expression levels of CD3-＋,CD4-＋,CD4-＋/ CD8-＋,and NK cells in the observation group were significantly lower than those in the control group,while CD8-＋level was significantly higher than that in the control group（ P〈0. 05）. The expression levels of CD3-＋,CD4-＋,CD4-＋/ CD8-＋,and NK cells before operation were significantly lower than those 7d after operation,while CD8-＋level was significantly higher than that 7d after operation（ P〈0. 05）. The expression levels of CD3-＋,CD4-＋,CD4-＋/ CD8-＋,and NK cells before operation in patients at stage I and II were significantly lower than those in patients at stage III andIV,while CD8-＋level was significantly higher than that in patients at stage III and IV（ P〈0. 05）. Conclusions： Detection of the expression levels of peripheral blood T cell subsets and NK cells in patients with gastric cancer in the clinic can be served as the important indicator to evaluate the immunological function status,and is of great significance in estimating the condition and assessing the prognosis.