结直肠癌患者细胞免疫功能的影响因素分析

目的探讨影响结直肠癌患者细胞免疫功能的相关因素。方法通过流式细胞仪检测224例患者外周血CD4+、CD8+细胞计数,计算CD4+/CD8+比值,将CD4+细胞计数或CD4+/CD8+低于正常值判定为细胞免疫功能低下,分析各种临床参数与两类细胞计数、比值及细胞免疫功能低下之间的关系,筛选出可能的影响因素。结果 CD4+细胞计数女性及Ⅰ、Ⅱ期患者分别高于男性及Ⅲ、Ⅳ期患者;CD8+细胞计数球蛋白降低组显著降低,总胆固醇升高或降低组显著高于正常组;CD4+/CD8+男性、总胆固醇升高或降低及Ⅲ、Ⅳ期患者分别低于女性,总胆固醇正常,Ⅰ、Ⅱ期患者,球蛋白降低组显著高于正常组;单因素分析显示Ⅲ、Ⅳ期及CEA正常的患者出现细胞免疫功能低下的比例分别高于Ⅰ、Ⅱ期及CEA升高患者;多因素分析显示患者性别及肿瘤分期与细胞免疫功能低下显著相关。结论男性及分期晚的患者更应该注重免疫治疗,及时纠正患者的营养不良状况有助于细胞免疫功能的保护。

The influencing factors to the cellular immune function of patients with colorectal cancer

Objective To explore the possible influencing factors to the cellular immune function of patients with colorectal cancer. Methods The cellular immune function was represented by the ratio of CD4＋/ CD8＋ and cell count of CD4＋ , CD8＋ T cells in peripheral blood of 224 patients. The cell count was detected by flow cytometry. The patient was regarded with low cellular immune function when the cell count of CD4＋ or the ratio of CD4＋/CD8＋ is under normal value. The relationship between different clinical data and the cell count of CD4＋, CD8＋ , the ratio of CD4＋/CD8＋ or low cellular immune function was analyzed to find the possible influencing factors. Results The cell count of CD4＋ T cells was significantly higher in female and staging I , I] patients than male and staging II1, 1V patients. The cell count of CD8＋ T cells was significantly lower in patients with hypo-globulin and higher in patients with hyper or hypo-total cho- lesterol than those with normal level of globulin or total cholesterol. The ratio of CD4＋/CD8＋ was significantly lower in male, hyper or hypo-total cholesterol and staging Ⅲ ,Ⅳ patients than female, normal level of total cholesterol and staging Ⅰ , Ⅱ patients. Single factor analysis showed that the probability of low cellular immune function was significantly higher in staging Ⅲ and IV or normal level of CEA than staging Ⅰ , Ⅱ or increased level of CEA patients. Multiple-factor analysis showed that the sex and staging of pa- tients were significantly correlative to low cellular immune function. Conclusion Male and later staging patients with colorectal cancer should receive more immunotherapy. To correct the malnourished condition of patients would be beneficial to the protecting of cellular immune function.