乳腺癌术后硅胶假体植入对免疫系统的影响

目的:探讨早期乳腺癌在行保留皮肤的乳腺癌切除术后应用硅胶假体植入即时乳房再造对机体免疫系统的影响。方法:于术前2d、术后3d和21d采集21例早期乳腺癌(～期)并采用自体组织移植或硅胶假体植入法实施即时乳房再造患者的外周血,应用流式细胞仪测定外周血中T淋巴细胞亚群的CD3+、CD4+、CD8+、CD4+/CD8+比值、NK细胞百分数及淋巴细胞转化率(LTT)。结果:1自体组织移植组CD3+、CD4+术前2d、术后3d均略有下降,但两者差别甚微,术后21d基本恢复;CD8+手术前、后变化不大;CD4+/CD8+比值术后3d较术前略微下降,但与术前相比无显著性差异,术后21dCD4+/CD8+比值恢复。三组间比较无显著性差异;NK细胞百分数术后略高于术前,但无显著性差异,LTT手术前后无显著性明显变化。2硅胶假体植入组术后3d、21dCD3+、CD4+均较术前有所回升,但三组间比较无显著性差异。CD8+变化不大,CD4+/CD8+比值术后3d、21d略高于术前。NK变化不明显。三组间比较均无显著性差异,LTT术前略高于术后,但手术前后无显著性差异。3两种乳房再造方法比较,假体植入组CD3+、CD4+、CD8+及CD4+/CD8+比值略高于自体组织组,NK细胞百分数和LTT,前者略低于后者。但两组间无显著性差异(P>0.05)。结论:早期乳腺癌术后采用硅胶假体植入法即时乳房再造对机体细胞免疫的影响与自体组织移植法相仿,两者均未对患者免疫功能造成显著影响。

Influence on the immunologic system in patients of breast cancer following immediate breast reconstruction with silicone gel implants after mastectomy

Objective: To evaluate the influence on the immunologic system in patients of early breast cancer following immediate breast reconstruction with silicone gel implants after mastectomy. Methods: On the 2 days preoperatively, 3 days and 21 days postoperatively, the percentages of T lymphocyte subset CD3 , CD4 , CD8 ,the ratio of CD4 / CD8 , NK cells and lymphocyte transformation test (LTT) in peripheral blood were determined by flow cytometry (FCM ) in 21 patients with breast cancer following immediate breast reconstruction with silicone gel implants or auto-transplantation after mastectomy. Results: The percentages of CD3 , CD4 , CD8 , the ratio of CD4 / CD8 , NK and LTT in peripheral blood slightly changed 2 days preoperatively, 3 days and 21 days postoperatively in the patients, but there was no obvious difference between the auto-transplantation group and the silicone implants group (P>0.05). Conclusion: The influence on the immunologic system in patients of early breast cancer following immediate breast reconstruction with silicone gel implants is similar to that with auto-transplantation after mastectomy. Neither of them influences the immunologic system obviously.