鼻咽癌病人放射治疗前后天然杀伤细胞活性、白细胞介素-2水平改变的研究

目的：探讨鼻咽癌(nasopharyngeal carcinoma,NPC)病人放射治疗前后天然杀伤细胞(NK细胞)活性、白细胞介素—2(IL-2)水平的变化和肿瘤复发转移的关系。方法：选择139例首诊的NPC病人为NPC组，45例健康成人为对照组，两组间性别及年龄无显著差异。NPC病人根据肿瘤有无复发转移又分为两组，均予以^60Coγ射线外照射DT68—80Gy，分别检测放疗前和放疗后(36个月内)及对照组的NK细胞活性及IL-2水平，观察肿瘤复发转移的情况。结果：鼻咽癌病人放疗前、后0-30个月内NK细胞活性及IL-2水平动态观察均明显低于正常对照组(P＜0．05)，至放疗30个月后NK细胞活性及IL-2水平恢复近正常水平。肿瘤复发转移者其NK细胞活性及IL-2水平明显低于无复发转移者(P＜0．05)。30个月内肿瘤复发转移率为85．7％(60/70)。结论：NPC病人免疫功能状况与肿瘤复发转移关系密切。动态观察和评价NK细胞活性及IL-2水平对判断NPC是否复发和转移有一定的指导意义。

Change in NK cell activity and IL-2 level of patients with nasopharyngeal carcinoma before and after radiotherapy

Objective To determine the change in NK cell activity and IL-2 level of patients with nasopharyngeal carcinoma (NPC) before and after the radiotherapy, to investigate the recurrence and metastasis of tumor, and to assess the relationship between immunological function of the patients and the recurrence and metastasis of tumor. Methods We selected 139 preliminarily diagnosed patients as NPC group and 45 normal adults as controls. In the NPC group, patients were divided into two groups based on the recurrence and metastasis. All patients were irradiated with 68- 80 Gy 60Coy-rays. NK cell activity and IL-2 level of the two groups were determined; and the recurrence and metastasis of tumor were detected. Results NK cell activity and IL-2 level of the patients with NPC either before or 0-30 months after the radiotherapy were significantly lower than those of the control group ( P <0.05). Thirty months after the radiotherapy NK cell ractivity and IL-2 level restored to the normal level. NK cell activity and IL-2 level in patients with recurrence and metastasis were significantly lower than those who had no recurrence and metastasis ( P <0.05); NK cell activity and IL-2 level in patients without recurrence and metastasis restored to the normal level 24 months after the radiotherapy. The recurrence and metastasis rate was 85.7% (60/70). Conclusion The immunological function of the patients had close relationship with the recurrence and metastasis of tumor. Dynamic observation and assessment of NK cell activity and IL-2 level are of significance in detecting the recurrence and metastasis of tumor.