胃癌根治术前后红细胞与淋巴细胞免疫功能改变的临床意义

目的　探讨胃癌患者手术前后红细胞免疫功能、T细胞亚群的变化及其相关性 ,为其免疫防治提供理论依据。方法　应用免疫粘附法和SAP法对 3 5例胃癌患者手术前后的红细胞免疫活性 (RBC -C3bRR、RBC -ICR和RBC -TRR )和外周血T细胞亚群 (CD3 、CD4 、CD8 和CD4 /CD8 )进行检测。结果　手术前红细胞C3bRR、TRR和CD3 、CD4 及CD4 /CD8 显著低于手术后和正常对照组 ( 3 2例 ) (P <0 .0 1)。而RBC -ICR和CD8 在手术前显著高于手术后和对照组 (P <0 .0 1)。胃癌患者手术前后的红细胞C3bRR和TRR与CD4 /CD8 均呈正相关 (P<0 .0 5 )。结论　手术可以明显改善胃癌患者红细胞与淋巴细胞的免疫功能。动态联合检测上述指标有助于了解病情严重程度 ,监测手术效果及开展围手术期免疫保护。

Clinical significance of erythrocyte immunity and T- lymphocyte subsets in patients with gastric cancer before and after operation

Objective To discuss the changes of erythrocyte immunity and T-lymphocyte subsets and their relationship in patients with gastric cancer before and after operation.Methods In 35 cases of gastric cancer and 32 healthy people as control,RBC-C3bRR,RBC-ICR and RBC-TRR were tested by immune adherence rosette method. T-lymphocyte subsets were tested by SAP assay.Results The value of RBC-C 3bRR,RBC-TRR,the percentage of CD3 ,CD4 and the CD4 /CD8 ratio were significantly lower in the preoperative group than in the postoperative group and the control group(P<0.01).The value of RBC-ICR and the percentage of CD8 were obviously increased in the preoperative group as compared with those in the postoperative group and the control group(P<0.01).The CD4 /CD8 ratio was significantly correlated with the value of RBC-C3bRR and RBC-TRR in the gastric cancer group before and after operation(P<0.05).Conclusion The operation may significantly improve the immune function of erythrocytes and lymphocytes in patients with gastric cancer.The detection of the above indexes is useful to understand the severity of the disease,to monitor the outcome of the operation and to carry out immune protection before and after the operation.