术前放化疗对老年直肠癌患者免疫功能的影响

目的探讨术前同期放化疗对进展期中低位直肠癌老年患者的细胞免疫功能的影响.方法35例60～75岁之间进展期中低位直肠癌老年患者,采用术前口服化疗药物卡培他滨（Capecitabine,Xeloda）单药方案,每日1000mg/m^2,连用2两周,休息1周,共两个疗程;放疗选择在口服化疗药物2d后进行,采用常规分割放疗,照射次数10次,三野照射总计量30Gy.治疗结束3周后手术.分别于入院当天、手术前1天,手术后7d,术后1月抽取患者外周血,采用流式细胞术（flow cyometry,FCM）检测T细胞亚群百分率（CD3^＋、CD4^＋、CD8^＋、CD4^＋/CD8^＋）及NK细胞含量变化.结果术前放化疗前后,患者外周血CD3^＋、CD4^＋、CD8^＋、CD4^＋/CD8^＋及NK细胞水平无明显差异（P〉0.05）,手术后7d、CD3^＋、CD4^＋、CD4^＋/CD8^＋及NK细胞水平较入院当天明显降低,CD8^＋升高（P〈0.05）,术后1月CD3^＋、CD4^＋、CD4^＋/CD8^＋及NK细胞含量较术后第7天均升高,CD8^＋明显降低（P〈0.05）,与术前相比细胞免疫无明显差异（P〉0.05）.结论术前同期放化疗对进展期中低位直肠癌老年患者的细胞免疫功能无明显影响,是一种安全有效的治疗方法.

The Influence of Preoperative Chemoradiotherapy on Immunity Function in Elderly Patients with Colorectal Cancer

Objective To study the influence of preoperative chemoradiotherapy on immunity function in elderly patients with advanced colorectal cancer. Methods 35 elderly patients （age from 60 to 75） with advanced colorectal cancer underwent 2 cycles chemotherapy preoperatively with single-drug regimen （oral capecitabine, 1 000 mg/m^2 for 2 weeks, then Rests for one week）, two days later, radiotherapy was applied with conventional radiotherapy at the total dose of 30 Gy in 10 fractions, completed in two weeks. Surgery were performed three weeks later. Blood samples were drawn separatedly at the day of admission, 1 day before operation, 7 day and 1 month after operation, and we used the Flow Cytometry to detect the level of CD3^＋, CD4^＋, CD8^＋, CD4^＋/CD8^＋ and NK cell. Results There was no significant difference in the levels of CD3^＋, CD4^＋, CD8^＋, CD4^＋ / CD8^＋, NK cell between before and after radiotherapy （P 〉 0.05）. 7 days after operation, the levels of CD3^＋, CD4^＋, CD4^＋/CD8^＋ and NK cells were degraded and CD8^＋ increased significantly （P 〈 0.05 ）. One month after operation, the level of CD3^＋ CD4^＋, CD4^＋/CD8^＋ and NK cells were higher than normal, and CD8^＋ was depressed signif- icantly （P 〈 0.05）. Gonelusion Preoperative chemoradiotherapy has no significant impact on cellular immune function in elderly patients with colorectal cancer, it is an effective and safe treatment methods.