腹腔化疗对老年结直肠癌病人手术后细胞免疫功能的影响

目的：探讨老年结直肠癌病人手术后腹腔化疗对免疫状况的影响。方法：对1998年1月至2002年12月60岁以上行根治性手术的52例结直肠癌病人进行腹腔化疗前后细胞免疫检测，并将之与我院同期健康老年对照组和行静脉化疗病例进行比较。所有病人于化疗前1d和化疗后1周早晨空腹时静脉采血，测定血清中NK细胞和T细胞亚群。结果：老年结直肠癌病人手术后CD4^＋和NK细胞水平明显低于健康老年人群；老年结直肠癌病人化疗后CD4^＋、CD4^＋／CD8^＋和NK细胞水平低于化疗前，其中静脉化疗病人化疗后较化疗前明显降低，存在统计学意义（P〈0．05）；而腹腔化疗组病人化疗前后上述指标的变化不大，无统计学意义（P〉0．05）。结论：针对老年病人的免疫特点，采用细胞免疫抑制较轻的腹腔化疗方式进行化疗，对老年结直肠癌病人有一定的临床价值。

Effect of Intraperitoneal Chemotherapy on Immune Function in Elderly Patients with Colorectal Cancer After Radical Operation

Objective:To investigate the effect of intraperitoneal chemotherapy on immune function in elderly patients with colorectal cancer after radical operation.Methods:From Jan. 1998 to Dec. 2002, NK cell and T cell subgroup of 52 elderly patients with colorectal cancer were measured 1 day before and 7 days after intraperitoneal chemotherapy. The results were analyzed with those of normal old people and those of intravenous chemotherapy.Results:The levels of CD4 +,CD4 +/CD8 +and NK cell were lower in elderly patients with colorectal cancer than those of the normal old people. The levels of CD4 +,CD4 +/CD8 + and NK cell decreased in elderly patients with colorectal cancer after intravenous chemotherapy and had no distinct change after intraperitoneal chemotherapy.Conclusion:It is essential to treat elderly patients with colorectal cancer after operation with intraperitoneal chemotherapy, which has less cellular immune damage.