| 食管胃交界部腺癌根治性手术对细胞免疫的影响 |
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| 引用本文： | 张勇,李守淼,黄玉梅,李敏,陈艳超,苏文中,胡广杰,李黎,黄艳玲. 食管胃交界部腺癌根治性手术对细胞免疫的影响[J]. 现代肿瘤医学, 2021, 0(1): 85-88. DOI: 10.3969/j.issn.1672-4992.2021.01.019 |
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| 作者姓名： | 张勇 李守淼 黄玉梅 李敏 陈艳超 苏文中 胡广杰 李黎 黄艳玲 |
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| 作者单位： | 安阳市肿瘤医院腹部肿瘤外科，河南 安阳 455000 |
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| 基金项目： | 河南省科技发展计划科技攻关项目(编号:172102310481)。 |
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| 摘 要： | 目的:探讨进展期食管胃交界部腺癌(AEGJ)患者围手术期外周血中淋巴细胞亚群及CD4+CD25+T细胞和程序性细胞死亡1（PD-1）在T淋巴细胞中表达的变化，了解根治性手术创伤对机体细胞免疫功能的影响及机制。 方法:126例进展期食管胃交界部腺癌行开腹根治性R0切除+D2淋巴结清除术，同期体检志愿者87例为对照组。应用流式细胞仪检测对照组和治疗组术前、术后1天、术后3天、术后7天和术后9天外周血CD3+、CD3+CD4+、CD3+CD8+、CD4+CD25+T细胞计数和PD-1在T细胞中的表达水平。结果:治疗组术前和对照组相比较，CD3+、CD3+CD4+T细胞均显著降低（P<0.05），而CD4+CD25+T细胞和PD-1在CD4+、CD8+T细胞的表达比例均显著增高（P<0.05）。CD4+CD25+T细胞的比例在术后1天迅速下降至谷底，随后逐渐升高，于术后7天达顶峰，然后再次下降。CD4+PD-1+T细胞的比例在术后显著增加:术后第1天达到最大值，然后逐渐下降，但在术后第7天仍显著高于术前。 CD8+PD-1+T细胞的比例则在术后逐渐增加，到术后7天达高峰。结论:食管胃交界部腺癌手术创伤可能是通过各种细胞因子导致CD4+PD-1+T细胞比例改变，进而调节T淋巴细胞亚群比例，抑制细胞免疫能力。
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| 关 键 词： | 食管胃交界部肿瘤 根治术 围手术期 细胞免疫 |
Effects of radical gastrectomy of adenocarcinoma of the esophagogastric junction on cellular immune function |
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| ZHANG Yong,LI Shoumiao,HUANG Yumei,LI Min,CHEN Yanchao,SU Wenzhong,HU Guangjie,LI Li,HUANG Yanling. Effects of radical gastrectomy of adenocarcinoma of the esophagogastric junction on cellular immune function[J]. Journal of Modern Oncology, 2021, 0(1): 85-88. DOI: 10.3969/j.issn.1672-4992.2021.01.019 |
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| Authors: | ZHANG Yong LI Shoumiao HUANG Yumei LI Min CHEN Yanchao SU Wenzhong HU Guangjie LI Li HUANG Yanling |
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| Affiliation: | Department of Abdominal Tumor Surgery，Anyang Tumor Hospital，Henan Anyang 455000，China. |
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| Abstract: | Objective:To evaluate cells ratios of T lymphocyte subsets and expression of programmed cell death 1(PD-1)in lymphocytes following surgery for advanced adenocarcinoma of esophagogastric junction(AEGJ),and to understand the effect of radical surgical trauma on cellular immune function.Methods:In 126 patients with advanced AEGJ,radical open abdominal R0 resection and D2 lymphnode dissection were performed,while 87 patients with concurrent physical examination were in the control group.Peripheral blood levels of CD3^+,CD3^+CD4^+,CD3^+CD8^+,CD4^+CD25^+T lymphocyte and expression of PD-1 in lymphocytes were measured by flow cytometry in the control group and the treatment group obtained pre-and post-operatively.Results:Compared with control group,preoperative ratios of CD3^+,CD3^+CD4 T cells were significantly reduced(P<0.05),and CD4^+CD25^+T cells ratio add PD-1 ration in CD4^+,CD8^+T cells were significantly increased(P<0.05).CD4^+CD25^+T lymphocyte count decreased rapidly from preoperative levels,reaching a minimum on post-operative day 1 and remaining significantly increased on days 3 and 7.CD4^+PD-1^+T lymphocytes significantly increased,reaching a maximum on postoperative day 1 and remaining significantly elevated on day 3.CD8^+PD-1^+T lymphocytes significantly increased and reached a maximum on day 7.Conclusion:Surgical trauma of AEGJ may be caused by changes in the proportion of CD4^+PD-1^+T lymphocytes caused by various cytokines,thereby regulating the proportion of T lymphocyte subsets and inhibiting the cellular immunity. |
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| Keywords: | esophagogastric junction neoplasms radical operation perioperative cellular immune |
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