化疗对晚期胃肠道恶性肿瘤患者细胞免疫功能的影响

目的 通过对晚期胃肠道恶性肿瘤患者化疗前后外周血辅助性T细胞分泌的Th1型细胞因子（IL-2）和Th2型细胞因子（IL-10）的检测,探讨化疗对晚期胃肠道肿瘤患者细胞免疫功能的影响.方法 分组对照研究,患者组晚期胃肠道肿瘤患者43人,分别在化疗前及化疗两周期结束后10d两次检测外周血Th1型细胞因子（IL-2）、Th2型细胞因子（IL-10）.设正常健康组25人为对照,相关试验结果进行统计学分析研究.结果 晚期胃肠道肿瘤患者与正常健康组相比,IL-2浓度明显下降,IL-10浓度明显升高,差异具有显著性（P＜0.05）.经过两周期的化疗治疗,化疗有效组患者（CR＋PR）化疗后IL-10则明显下降（P＜0.05）,但是仍达不到对照组的水平（P＜0.05）;而无效组患者（SD＋PD）化疗后,IL-10虽有升高,但与化疗前相比没有统计学意义.结论 晚期胃肠道肿瘤患者T淋巴细胞免疫功能低下,Th2类细胞因子呈优势表达状态.有效化疗可通过杀灭肿瘤细胞,改善了患者的细胞免疫功能.通过检测Th亚群细胞因子的变化可以反映患者的免疫水平及化疗疗效,对指导临床,判断预后有重要的意义.

Impact of chemotherapy on imune function of patients wit6h gastrointestinal malignant tumor at advanced stage

Objective To observe the effect chemotherapy on the immune function of patients with gastrointestinal malignant tumor in the later stage.Methods The changes of Th1(IL-2)and Th2(IL-2)cytokines in peripheral blood of the patients before and after chemotherapy were determined.Results Before ehmocherapy the level of IL-2 in patients with gastrointestinal malignant tumor was significantly lower than that of normal group(P<0.05)and the the concentration of IL-10 was increased in tumor patients than that of normal controls(P<0.05).After chemotherapy of two courses,the level of IL-10 in the improved patients of observation group was lower significantly than that of before chemotherapy(CR PR),but the concentration could not reach the level of the normal group.The level of IL-10 decreased significantly in patients without improvement of the observation(SD PD)without showing significant difference compared with that before chemotherapy.Conclusion The immune function of T-lymphocyte subgroup is suppressed in the patients with gastrointestinal malignant tumor and the expression of Th2 type cytokines is enhanced.The tumor cells can be keilled by chemotherapy.The determination of Th1/Th2 cellular cytokines can ascertain the immune function of the patients and the the effect of chemotherapy that are useful for prognosis of the disease.