进展期胃癌围手术期细胞免疫水平变化及临床意义

目的:评价进展期胃癌患者围手术期外周血细胞免疫功能的动态变化及临床意义。方法:对47例胃癌手术患者进行了术前,术后第1天,术后第10天的CD3、CD4、CD8、CD4/CD8的检测,手术病例根据手术是否切除分为切除组、剖腹探查组,检测结果用spss13.0作统计分析。结果:切除组CD3、CD4术后10天较术前,术后1天相比有明显升高,术后10天即高于术前水平,有显著统计学意义(P<0.05)。该组CD8、CD4/CD8水平,术后10天与术前、术后1天比较,CD8均值下降、CD4/CD8均值上升。探腹组比较围手术期免疫水平变化主要表现为术后10天较术前相比,CD3、CD4、CD4/CD8上升,CD8下降,但CD3、CD4变化幅度远小于根治组,且无统计学意义。分期为IIIa,IIIb两组的CD3、CD4水平术后10天较术后1天,术前相比有明显上升,有统计学意义。结论:对胃癌患者应力争行根治性切除,对于较晚期患者,也力争最大限度地去除或减少肿瘤负荷,最大限度地减少免疫抑制因子的释放,促进机体免疫功能的恢复。

The Changes of Perioperative Cellular Immunity with Advanced Gastric Cancer and Its Clinical Signifi cance

Objective:To evaluate dynamic changes of perioperative cellular immune function of peripheral blood in advanced gastric cancer and it’s clinical significance.Methods:47 cases of gastric cancer patients with a CD 3,CD 4,CD 8,CD 4 /CD 8 testing on preoperative、 the first day after operation,the 10th day after operation,surgical cases devides into two groups which are resection group and laparotomy group according to whether the tumor is resected.The test results use spss 13.0 to statistical analysis.Results:The resection group,the level of CD 3,CD 4 is significantly increased when 10 days after surgery compare with the level fo the preoperative,the first day after operation.The level of CD3,CD4 when 10 days after operation is higher than the preoperative levels,there are statistically significant(P <0.05).The group of CD 8,CD 4 /CD 8 levels,CD 8 mean decline,CD 4 /CD 8 average rise.The immune changes in laparotomy group are that CD 3,CD 4,CD 4 /CD 8 increased,CD 8 down,but magnitude of changes in CD 3,CD 4 is far less than what in resection group,and no statistics significance.The changes of CD 3,CD 4 levels in Phases of IIIa,IIIb are the significant increase,and the changes is statistically significant.Conclusion:Radical resection should strive for patients with advanced gastric cancer,and we should strive to maximize the removal or reduction of tumor burden and minimize the release of immunosuppressive factors,and promote the recovery of immune function for late staged patients