不同分期的成骨肉瘤患者免疫学的变化

Changes of Immunological Function in Different Stages of Osteosarcoma

目的：评价成骨肉瘤患者临床分期与免疫学变化的关系及意义。方法：利用流式细胞仪检测120例成骨肉瘤患者淋巴细胞亚群、利用MTT法检测NK细胞活性，应用放射免疫分析法检测IL－2、TNF－α、β2－微球蛋白的变化，应用ELISA法检测SIL－2R的改变。结果：随着Enecking分期的增高，患者NK活性、CD4、CD4／CD8、IL－2逐渐下降，CD8、sIL－2R、β2－MG、TNF－α逐渐升高P＜0．01；Ⅱa期成骨肉瘤患者机体免疫功能活跃，CD3、CD4、NK活性及IL－2、sIL－2R高于对照组P＜0．01，其余指标与对照组相同；Ⅰb及Ⅱb组患者各项指标改变明显；Ⅲ期肿瘤CD4、CD4／CD8、IL－2较Ⅱ期明显降低sIL－2R、TNF－α急剧升高P＜0．01。结论：成骨肉瘤患者免疫功能与疾病分期呈负相关，淋巴细胞亚群、sIL－2R、IL－2可作为监测患者病情改变的指标。

Objective To evaluate the changes of immunity function in different stages of osteosarcoma． Methods T lymphocyte subset was measured using flow cytometry NK cells detected by MTT and serum levels of IL－2 TNF－α sIL－2R β2－MG were observed by RIA and ELISA． Results NK CD4 CD4／CD8 IL－2 decreased gradually while CD8 sIL－2R B 2MG increased along with the progress of osteosarcoma from Ⅱa and Ⅲ stage P＜0．01． The NK CD4 CD4／CD8 sIL－2R and IL－2 in patients with osteosarcomain Ⅱa were significantly higher than those in controls P＜0．01 but CD8 TNF－α β2－MG in these patients were no difference from controls． The levels of TNF－α sIL－2R were significantly higher but CD4／CD8 IL－2 were lower in patients in stage Ⅲ than that in Ⅱb． Conclusion The preoperative immune status of osteosarcoma patients is negatively related to the stage of the disease． The changes of immunity may be served as a means to observe the condition of osteosarcoma patients．