康莱特注射液对现代二野清扫术食管癌患者围术期细胞免疫支持治疗的临床随机对照研究

目的作者前期的研究证实食管癌患者存在明显的细胞免疫功能抑制，手术创伤引起食管癌的暂时性细胞免疫抑制，本研究旨在观察细胞免疫支持治疗对食管癌患者围术期细胞免疫机能的影响。方法采用前瞻性的临床随机对照研究，60例施行现代二野清扫术的胸段食管癌患者随机分成对照组与治疗组，治疗组术后应用康莱特注射液。抽取术前、术后3天、术后9天的外周血，分别利用KL型肿瘤免疫图象分析系统检测AgNOR活性表达，流式细胞术分析T淋巴细胞亚群。结果对照组的围术期细胞免疫的变化规律：术后第3天细胞免疫功能下降最为明显，但从第3天开始可观察到细胞免疫功能恢复趋势，术后第9天继续恢复，但仍未恢复到正常水平。治疗组的围术期细胞免疫的变化规律：AgNOR、CD3^＋、CD3^＋CD4^＋术后3天已经恢复至术前水平，其中AgNOR、CD3^＋术后9天上升更为明显，高于术前水平；CD3^＋CD8^＋、CD4^＋CD25^＋表现为术后逐渐增高，术后9天明显高于术前水平（P〈0．05）。术后第3天AgNOR、CD3^＋CD4^＋、CD4^＋／CD8^＋治疗组明显优于对照组（P〈0．05）；术后第9天AgNOR、CD3^＋与CD4^＋CD25^＋治疗组明显优于对照组（P〈0．05）。结论治疗组患者术后应用康莱特注射液能明显改善现代二野清扫术的胸段食管癌患者因肿瘤及手术而引起的免疫细胞抑制作用，尤其是以AgNOR、CD3^＋、CD3^＋CD4^＋及CD4^＋CD25^＋T淋巴细胞的功能改善最为明显。

Immunotherapy with Kanglaite injection for perioperative patients of esophageal carcinoma with modern two-field LN dissection

Objective To observe the effect of Kanglaite injection on the cellular immune response in perioperative patients of esophageal carcinoma.Methods Randomized controlled clinical trial was used in the study.Sixty cases of thoracic esophageal carcinoma who received modern two-field dissection were randomly divided into control group and treatment group(Kanglaite injection was used postoperationally).Peripheral blood samples were obtained before surgery,3 days and 9 days after surgery.AgNOR activity in T lymphocytes was measured by KL tumor immune microphotometry,and T cell subsets were detected by flow cytometry.Results The recovery of cellular immune function started from the 3rd day till the 9th day after operation in the control group,but not to the normal level.In the treatment group,the mean values of AgNOR,CD3~+,CCD3~+CD4~+ were recovered to the preoperative level at the 3rd day,and even higher than those of preoperative level at the 9th day.The mean values of CD3~+CD8~+,CD4~+CD25~+ increased gradually after operation,and were higher than those of preoperative levels at the 9th day(P<0.05).The mean values of AgNOR,CD3~+CD4~+,CD4~+CD8~+ in treatment group were higher than those of control group at the 3rd day after operation(P<0.05).The mean values of AgNOR,CD3~+ and CD4~+CD25~+ in treatment group were much higher than those of control group at the 9th day after operation(P<0.05).Conclusion Kanglaite injection can improve cellular immunity of patients with esophageal carcinoma undergoing modern two-field LN dissection significantly.