结肠癌患者血中几种细胞因子的变化与生活质量的相关意义

Changes of some cell factors in the blood of colon cancer patients and its correlated significance with quality of life

目的研究手术前期及术后恢复期结肠癌患者血中几种细胞因子的变化,探讨其在不同疾病状态下,特别是恢复阶段的变化及与生活质量的相关意义。方法采用ELISA法对细胞因子白细胞介素10(IL-10)、白细胞介素18(IL-18)进行测定,采用APAAP法测定T淋巴细胞亚群,采用单向免疫扩散法测定免疫球蛋白。结果(1)手术前期结肠癌患者血中IL-10明显增高,IL-18明显下降,尤其以伴有转移者为著。(2)手术前期结肠癌患者血中,CD3+、CD4+细胞明显下降,CD4+/CD8+比值下降;(3)手术前期结肠癌患者免疫球蛋白IgG、IgA、IgM明显降低;(4)术后3个月患者进入术后恢复期后复查,在非转移组,各项指标均有不同程度恢复。(5)术后生活质量评分,非转移组高于转移组。结论手术前期结肠癌患者体内存在着严重的体液免疫及细胞免疫功能失调,且二者相互影响。IL-18,IL-10,免疫球蛋白,T细胞亚群在一定程度上反映了患者机体免疫状态。非转移性肿瘤,术后恢复期免疫功能改善,生活质量提高,证明上述几项检查在结肠癌患者病情的判定及疗效评价、恢复情况判断上具有重要意义。

Aim To study the changes of some cell factors in the blood of colon cancer patients, and its correlated significance with quality of life (QOL) in the state of different diseases, especially during the recovery period. Methods Forty six patients with colon cancer, 29 males and 17 females, aged 32- 79 years old, including 16 cases of metastasis, were used in the study. Twenty normal volunteers, 10 males and 10 females, aged 22- 46 years old, were used as controls. Interleukin 10(IL 10) and interleukin 18(IL 18) were detected with ELISA technique, T lymphocyte with APAAP technique, and immunoglobulin with one way immunodiffusion technique. Results (1) Before operation, the level of IL 10 increased and IL 18 decreased significantly in the colon cancer patients, especially in the metastatic patients. (2) The concentrations of CD3+ and CD4+ decreased and that of CD4+ /CD8+ decreased significantly in the colon cancer patient before operation. (3) In the colon cancer patients, the concentrations of IgG, IgA and IgM decreased significantly before operation. (4) In the recovery phase after 3 month operation, in the non metastatic group, every marker had different degree reversion. (5)The QOL score of the non metastatic groups were higher than that of the metastatic groups. Conclusion There are serious humoral immunity and cellular immunity disturbance in the preoperation phase patients with colon cancer, which interaction each other. IL 10, IL 18, immunoglobulin, T lymphocyte subtype can reflect the body' immune state in some degree. The high of the non metastatic groups' QOL Score prove the important significance of the cell factors for the determinating patient's status, cure effect and recovery condition.<P>