梗阻性大肠癌患者术前外周血细胞免疫水平检测及其临床意义

为观察梗阻性因素对大肠癌患者术前外周血细胞免疫水平的影响，探讨其对一期切除吻合术式选择的影响，我们使用流式细胞仪对21例梗阻性大肠癌患者、72例非梗阻性大肠癌患者术前3d内外周血T淋巴细胞亚群、自然杀伤（NK）细胞活性进行检测，并选取同期15名健康志愿者作为对照，进行对比分析。结果显示，与对照组相比，梗阻性大肠癌组和非梗阻性大肠癌组外周血CD3^＋、CD4^＋、CD4^＋／CD8^＋比值及NK细胞显著减少（P〈0．01），CD8^＋细胞增多（P〈0．01）；但梗阻性大肠癌组T细胞亚群和NK细胞与非梗阻性大肠癌组相比，差异无统计学意义（P〉0．05）。结果表明，单从细胞免疫角度进行考虑，梗阻性因素并不影响对大肠癌患者行一期切除吻合术式的选择。

Preoperative Detection of Cellular Immune Level of Peripheral Blood in Patients with Obstructive Colorectal Carcinoma and its Clinical Significance

For the objective of investigating the impact of obtructive factors on the cellular immune level of patients with colorectal carcinoma, the activity of T lymphocyte subset and NK cell was detected 3 days before surgical operation for obstructive colorectal carcinoma of 21 cases（the study group Ⅰ ） and non-ob- structive colorectal carcinoma of 72 cases（the study group Ⅱ） ,and healthy volunteers of 15 cases （the control group）;the detection results were analized. As results, the specific value of CD3^＋ ,CD4^＋ and CD4^＋/ CD8^＋ of peripheral blood as well NK cells were notably reduced in study group Ⅰ and group Ⅱ （ P 〈 0.01） ;the number of CD8^＋ cells was raised（ P 〈0.01）;while the T lymphocyte suhest and NK cell between the two study groups had no statistical difference（ P 〉0.05）. It is showed that obstruction,from the angle of cellular immunity alone, can not influence the option of primary incision and anastomosis in surgical treatment of colorectal carcinoma.