胃癌病人手术前后免疫功能的观察

The Observation of Immune Function in Preoperative and Postoperative Patients with Gastric Cancer

目的 :探讨胃癌病人手术前后体液免疫和细胞免疫水平的变化及其临床意义。方法 :对 47例胃癌病人在术前和术后 2 0d外周血样用单扩散法分别作血清免疫球蛋白IgA、IgG、IgM的测定 ,采用单克隆抗体免疫组化法测定外周血T淋巴细胞亚群CD+ 3 、CD+ 4、CD+ 8、CD+ 4/CD+ 8的值 ,并与 47例正常对照比较。结果 :胃癌病人手术前后免疫球蛋白水平无明显差异 ,与正常对照组比较亦无显著性差异 (P >0 .0 5 )。与正常组比较 ,胃癌病人手术前的CD3 、CD64 、CD+ 44 /CD+ 8降低而CD+ 8升高 ,差异非常显著 (P <0 .0 1)。与术前比较 ,手术后 2 0d的CD+ 3 、CD+ 4、CD+ 4/CD+ 8升高而CD+ 8降低 ,差异有显著性 (P <0 .0 5 ) ,且与正常对照组比较差异无显著性 (P >0 .0 5 )。结论 :胃癌病人肿瘤的消长与细胞免疫功能有密切关系 。

Objective:To evaluate the changes and clinical implication of humoral and cellular immune functions in patients with gastric cancer before and after operation.Methods:Peripheral blood(preoperationa and at 20 days after operation)of 47 patients with gastric cancer and 47 normal subjects were collected.Serum IgA?IgG?and IgM were measured. Immunohistochemical determination of CD + 3?CD + 4?CD + 8?CD + 4/CD + 8 was carried out.Results:There were not differences of serum levels of immunoglobins between preoperation and postoperation groups and nor between patients with gastric cancer and control patients. Compared to control group, CD + 3?CD + 4?CD + 4/CD + 8 of preoperative patients were significantly lower and CD + 8 was significantly higher (P<0.01). At 20 days after operation, CD + 3?CD + 4?CD + 4/CD + 8 increased and CD + 8 deceseased, compared to preoperation (P<0.05), and the data after operation were similar to those in control group (P>0.05). Conclusion: Cellular immune function instead of humoral immune function in patients with gastric cancer is related to tumor progress.