日达仙对现代二野清除术食管癌患者围术期细胞免疫支持治疗的随机对照研究

目的:探讨细胞免疫支持治疗对食管癌患者围术期细胞免疫机能的影响。方法:采用前瞻性的临床随机对照研究,60例施行现代二野清除术的胸段食管癌患者随机分成对照组与治疗组,治疗组术后应用日达仙。抽取术前、术后d3、术后d9的外周血,分别利用KL型肿瘤免疫图像分析系统检测AgNOR活性表达,流式细胞术分析T淋巴细胞亚群。结果:治疗组的围术期细胞免疫的变化规律:AgNOR、CD3 、CD3 CD4 术后d3已经恢复至术前水平,术后d9上升更为明显,高于术前水平;CD3 CD8 、CD4 CD25 表现为术后逐渐增高,术后d9明显高于术前水平,P<0·05。术后d3AgNOR、CD3 CD4 、CD4 /CD8 治疗组明显优于对照组,P<0·05;术后d9AgNOR、CD3 与CD4 CD25 治疗组明显优于对照组,P<0·05。结论:治疗组患者手术后应用日达仙后能明显改善现代二野清除术的胸段食管癌患者因为肿瘤及手术而引起的免疫细胞抑制作用,尤其是以Ag-NOR、CD3 、CD3 CD4 及CD4 CD25 T淋巴细胞的功能改善最为明显。

Clinical random control study of cellular Immune supportive treatment with zadaxin for perioperative patients with modern two-field LN dissection esophageal carcinoma

OBJECTIVE:This study was to detect the cellular immune supportive treatment effect for perioperative patients with esophageal carcinoma. METHODS: Prospective clinical random control study was used. 60 cases of thoracic esophageal carcinoma, which were performed modern two-field dissection ,were randomized into control group and treatment group (Zadaxin was used postoperation). Peripheral blood samples were obtained from 60 patients with esophageal carcinoma before surgery, 3, and 9 days after surgery. AgNOR activity in peripheral blood T lymphocytes was measured by tumor immune microphotometry, T cell subsets were measured by flow cytometry. RESULTS: In the treatment group, the mean value of AgNOR, CD3~ , CD3~ CD4~ in 3 days after operation had recoveried to the preoperative level, they were much higher in 9 days after operation than that of the preoperative level; The mean value of CD3~ CD8~ , CD4~ CD25~ increased gradually after operation, they were much higher in 9 days after operation than that of the preoperative level (P<0.05). The mean values of AgNOR, CD3~ CD4~ , CD4~ /CD8~ in treatment group were much higher than that of control group at 3 days after operation (P<0.05); The mean values of AgNOR, CD3~ and CD4~ CD25~ in treatment group were much higher than that of control group at 9 days after operation (P<0.05). CONCLUSION: Zadaxin could improve cellular immunity of the esophageal carcinoma patients with modern two-field LN dissection obviously, especially improved in AgNOR, CD3~ , CD3~ CD4~ and CD4~ CD25~ T lymphocyte.