放射治疗对食管癌患者免疫功能的影响

Influence of radiotherapy on the immune function of patients with esophageal carcinoma

目的 :探讨放射治疗 (放疗 )对食管癌患者机体免疫功能的影响。方法 :采用单扩散 (SRID)法、酵母花环法检测 6 5例食管癌患者血清免疫球蛋白水平、外周血T淋巴细胞亚群和红细胞免疫功能。结果 :放疗后食管癌患者免疫球蛋白无明显变化(P >0 .0 5 ) ;与放疗前相比 ,总T细胞 (CD3+ )无明显降低 (P >0 .0 5 ) ,CD4 + T细胞明显下降 (P <0 .0 1) ,CD8+ T细胞上升(放疗后 3个月时 ) (P <0 .0 5 ) ;CD4 + /CD8+ 明显低于放疗前 (P <0 .0 1) ,一直延续到放疗后 6个月 (P <0 .0 1) ;与放疗前比较 ,红细胞C3b受体花环 (RBCC3bRR)明显下降 (P <0 .0 1) ,红细胞免疫复合物花环 (RBCC3bICR)无明显变化。结论 :食管癌患者放疗后 ,免疫功能受损或抑制 ,调节功能紊乱还会持续一段时间 ,增加宿主对抗肿瘤的功能 ,放疗的同时就增加免疫治疗 。

Objective:To investigate the influence of radiotherapy on the immune function of patients with esophageal carcinoma.Methods:The serum immunoglobulin level of patients with esophageal carcinoma was measured using single radial immunodiffusion(SRID).The T lymphocyte subset proportions in peripheral blood of patients were detected by the SRID assay.And the erythrocyte immune function was estimated by the Yeast rosettes assay.Results:There were no obvious changes in serum Ig level or the proportion of total T lymphocytes(CD3 +)(both P >0.05) in all patients after radiotherapy.In contrast to the increased cell protortions of CD8\++ T cells( P <0.05).The cell account of CD4\++ T cells decreased significantly( P <0.01) and the ratio of CD4\++/CD8\++ T cells lowered greatly( P <0.01) in all patients after radiotherapy,which lasted for 6 months after radiotherapy.In addition,the erythrocyte C3b rosettes of patients decreased( P <0.01) after radiotherapy.Conclusions:The immune function of patients with esophageal carcinoma is suppressed after radiotherapy and disturbance of immunomodulation will stay for a longer period.The patients with esophageal carcinoma who are receiving radiotherapy should be supplemented with immunotherapy in order to enhance the immune function.