消化道癌肿患者围手术期免疫功能测定

消化道恶性肿瘤治疗、预后与肿瘤免疫密切相关，其中Ｔｃ介导免疫是肿瘤免疫的主要方面。对３０例消化道恶性肿瘤患者及正常人外周血Ｔｃ亚群进行测定，并将肿瘤患者手术前后１０天Ｔｃ亚群的改变量进行了平行比较，发现肿瘤患者ＣＤ３、ＣＤ４明显下降，而ＣＤ８明显上升，从而导致ＣＤ４／ＣＤ８比值下降（Ｐ＜０．０１）；术后１０天肿瘤患者免疫功能较术前有不同程度的改善，ＣＤ３、ＣＤ４上升，ＣＤ８下降，ＣＤ４／ＣＤ８比值上升（Ｐ＜０．０１）。但与正常人相比，除ＣＤ８外其他仍显著低于正常人。研究资料表明肿瘤负荷使免疫功能呈负性状态，癌灶去除后使正性免疫功能得以不同程度的恢复，但术后仍需免疫辅助治疗以进一步改善免疫功能，提高手术治愈率。

DETERMINATION OF IMMUNOCOMPETENCE IN PERI-OPERATIVE PATIENTS WITH MALIGNANT TUMOR OF THE DIGESTIVE SYSTEM

The treatment and prognosis of the tumors of the digestive system are closely related to the biological status of the tumor immunity, especially to the T lymphocyte-mediated cellular immunity. We determined the T lymphocyte subsets in the peripherial blood samples collected from 25 normal controls and 30 patients with malignant tumors of the digestive system before and after operaiton. Before operation, the immunocompetence was suppressed in tumor patients, which was characterized by significantly decreased CD3, CD4subsets, increased CD8subset and consequently decreased CD4/CD8ratio(P<0.01). Ten days after operation,CD,and CD.were increased, CD8 was decreased, and CD4/CD8ratio was increased markedly, however, these values except CD8were still significantly lower than those in normal controls. These data suggested that the immunocompetence in patients with malignent tumors were remarkably suppressed when exposed to the burden of tumor, and restored to some degree after removal of the tumor. However, immunoassistant therapy is necessary for improvement of the immunocompetence and increase of the curative rate.