化疗对晚期肺癌患者T淋巴细胞亚群和红细胞免疫功能的影响

目的：分析42例晚期肺癌者化疗前后T淋巴细胞亚群和红细胞免疫功能的变化，并探讨其与病情的关系。方法：对42例晚期肺癌化疗前后的血标本采用流式细胞术检测T淋巴细胞亚群和采用交体粘附法检测红细胞免疫功能，并与体检健康者作比较，结果：本组晚期肺癌患者治疗前后T淋巴细胞亚群和红细胞免疫功能均低于对照组（P＜0．05，P＜0．01）。治疗后，化疗有效率总T细胞（CD3^ ）、辅助／诱导T淋巴（CD4^ ）、CD4^ 与CD8^ 比值均显著升高（P＜0．01），细胞毒／抑制性T淋巴细胞（CD8^ ）降低（P＜0．05）；化疗无效者CD3^ 、CD4^ 、CD4^ ／CD8^ 显著降低（P＜0．05，P＜0．01），而CD8^ 升高（P＜0．01），直向肿瘤红细胞花环（direct tumor erythrocyte rosette,DTER），红细胞C3b受体花环（red blood cell C3b receptor rosette,RBC-C3bRR)和红细胞免疫复合物花环（red blood cell immunity complex rosette,RBC-ICR)，化疗前后变化不明显（P＞0．05）。结论：晚期肺癌患者免疫功能低下，有铲化疗能提高患者的T淋巴细胞亚群免疫功能，临床上对免疫功能的观察对肺癌患者的治疗和预后有一定的监测作用。

Effects of Chemotherapy on T-lymphocyte Subgroup and Erythrocyte Immunity in Patients with Advanced Lung Cancer

Objective: To analyze the functional changes of T lymphocyte subgroups and erythrocyte immunity before and after chemotherapy and to explore the relationship between the changes and the severity of condition in the patients with advanced lung cancer. Methods: Using monoclonal antibodies,the change of T lymphocyte subgroups and erythrocyte immunity were measured with the flow cytometry and receptor adhering method before and after treatment in the patients with advanced lung cancer and compared with the control group. Results: The function of T lymphocyte subgroup and erythrocyte immunity were significantly lower in advanced lung cancer patients group than that in control group before and after chemotherapy (P< 0.05, P< 0.01). After chemotherapy, CD3+ and CD4+ cells and the ratio of CD4+/CD8+ were higher in the effective group than in pre treatment samples (P< 0.01), while CD8+ cells were lower than in pre treatment samples (P< 0.05). CD3+ and CD4+ cells and the ratio of CD4+/CD8+ were lower in the ineffective group than that in pre treatment samples (P< 0.05, P< 0.01), while CD8+ cells were higher than in pre treatment samples (P< 0.01). No significant changes of direct tumor erythrocyte rosette (DTER),red blood cell C3b receptor rosette (RBC C3bRR), and red blood cell immunity complex rosette (RBC ICR) positive were observed after chemotherapy (P >0.05). Conclusions: The immunity was suppressed in the patients with advanced lung cancer and immunity of the patients can be improved by effective chemotherapy. So clinical observation to the immunity of the patients with advanced lung cancer has certain surveilant function on the treatment and prognosis of the advanced lung cancer.