胃癌患者化疗前后血清β2微球蛋白、视黄醇结合蛋白、Hcy水平及T淋巴细胞亚群的变化及临床意义

Changes and clinical significance of serum β2-microglobulin,retinol conjugated protein,Hcy and T-lymphocyte subsets in patients with gastric cancer before and after chemotherapy

目的探讨胃癌患者化疗前后血清β2微球蛋白、视黄醇结合蛋白、同型半胱氨酸(Hcy)水平及T淋巴细胞亚群的变化及临床意义。方法选取89例胃癌患者,均接受根治性手术+辅助化疗。根据TNM分期不同,将胃癌患者分为Ⅲa期组(n=52)和Ⅲb期组(n=37);化疗后根据临床疗效分为有效组和无效组,将完全缓解(CR)和部分缓解(PR)患者纳入有效组,疾病稳定(SD)和疾病进展(PD)患者纳入无效组。选取同期50例健康体检者为对照组。于化疗前和化疗2个周期后采集胃癌患者的血液样本,对照组于体检时采集血液样本,检测血清β2微球蛋白、视黄醇结合蛋白、Hcy水平及T淋巴细胞亚群水平。结果化疗前Ⅲa期组和Ⅲb期组胃癌患者的CD3+、CD4+水平和CD4+/CD8+均低于对照组(P﹤0.05)。89例胃癌患者化疗后的血清β2微球蛋白、视黄醇结合蛋白、Hcy水平均明显高于化疗前,差异均有统计学意义(P﹤0.01)。化疗2个周期后,CR患者6例,PR患者64例,SD患者14例,PD患者5例。有效组胃癌患者(n=70)化疗后的CD3+、CD4+水平和CD4+/CD8+均明显高于化疗前(P﹤0.01)。无效组胃癌患者(n=19)化疗前后的CD3+、CD4+水平和CD4+/CD8+比较,差异均无统计学意义(P﹥0.05)。结论胃癌患者化疗后可能出现不同程度的肾功能不全,T淋巴细胞亚群对评估胃癌患者的化疗疗效具有一定价值。

Objective To study the changes and clinical significance of serum β2-microglobulin,retinol conjugated protein,homocysteine(Hcy)and T-lymphocyte subsets in patients with gastric cancer before and after chemotherapy.Method The medical records of 89 patients with gastric cancer admitted to the hospital were collected.All patients underwent radical surgery and neoadjuvant chemotherapy.According to the TNM staging,these gastric cancer patients were stratified as stage Ⅲa group(n=52)and stage Ⅲb group(n=37);furthermore,they were subdivided as per their response to therapy,and the response group included those who achieved complete response(CR)and partial response(PR),while those who had stable disease(SD)and progressive disease(PD)were included as non-response group.Another 50 healthy checker during the same period were allocated as the control group.Blood samples of patients with gastric cancer were collected before chemotherapy and after 2 cycles of chemotherapy,while those of the control group were collected during physical examination to detect levels of serum β2-microglobulin,retinol conjugated protein,Hcy and T-lymphocyte subsets.Result The CD3^+,CD4^+ and CD4^+/CD8^+ in stage Ⅲa group and stage Ⅲb group were significantly lower than those in the control group(P<0.05).After chemotherapy,levels of serum β2-microglobulin,retinol conjugated protein and Hcy were significantly increased in 89 patients with gastric cancer(P<0.01).After 2 cycles of chemotherapy,there were 6 cases of CR,64 cases of PR,14 cases of SD and 5 cases of PD.The CD3^+,CD4^+ and CD4^+/CD8^+ in response group(n=70)after chemotherapy were significantly higher than those before chemotherapy(P<0.01),while there was no significant difference in the non-response group(n=19)before and after chemotherapy(P>0.05).Conclusion Patients with gastric cancer may have different degrees of renal damage after chemotherapy.T-lymphocyte subsets is of certain value in evaluating the curative effect of chemotherapy in patients with gastric cancer.