3DCRT治疗中不同部位恶性肿瘤外周血免疫细胞的动态变化

目的　探讨 3D立体定向适形放射治疗 (3D CRT)前后不同部位恶性肿瘤患者T ,B淋巴细胞和NK细胞的变化。方法　应用流式细胞技术对 4 3例恶性肿瘤患者在 3D CRT前和后 1,4周外周血CD3 ,CD4,CD8细胞 ,CD4/CD8比值 ,CD19细胞和NK细胞的变化。结果　 (1)不同部位恶性肿瘤患者 3D CRT前CD3 ,CD4细胞 ,CD4/CD8比值 ,CD19及NK细胞均显著低于健康组 (P <0 .0 5 ,P <0 .0 1) ;(2 )照射后食管癌和直肠癌CD3 ,CD4细胞及CD4/CD8比值下降不明显 ,第4周时已回升 (P >0 .0 5 ) ;脑胶质瘤照射前后变化不显著 (P >0 .0 5 )。 (3)各类肿瘤照射期间CD19细胞、NK细胞无明显下降 (P >0 .0 5 )。结论　恶性肿瘤患者因 3D CRT治疗部位不同 ,其免疫功能细胞的改变有差异 ,临床可据此调整照射剂量、剂量分割及药物对抗。此外 ,CD19细胞和NK细胞对放疗的不敏感性是 3D CRT治疗的特点

Dynamic Changes of Peripheral Blood Lymphocyte Subsets and NK Cells in Patients with Different Cancers Undergoing 3 D-CRT

Objective To investigate the dynamic changes of T lymphocyte subsets and NK cell in patients with five kinds of malignant tumors before and undergoing 3 D conformal radiation therapy (3 D CRT). Methods Fourty three patients were studied in their peripheral CD 3, CD 4, CD 8 cells, CD 4/CD 8 ratio, CD 19 and NK cells by flow cytometry. Results 1. The CD 3, CD 4 cells, CD 4/CD 8 ratio in all the patients were statistically decreased before 3 D CRT than that in the control group ( P<0.05,P <0.01); 2. The CD 3, CD 4 cells, CD 4/CD 8 ratio in esophagus and rectal carcinomas were down quickly after 3 D CRT and slightly growing in the fourth week. Otherwise, these parameters were little changed in lung carcinoma and metastatic tumors. 3. The CD 19 and NK cells little sensitive to radiotherapy in every kind of tumor in this group. Conclusion The T lymphocyte subsets in the patients with varied kind of carcinomas show different sensitivity to 3 D CRT. It is characterized by that 3 D CRT is little harm to NK cells.