妇科肿瘤患者不同状态下的免疫功能评价

摘要

目的：研究妇科肿瘤患者的免疫功能变化情况，观察机体免疫功能与患者年龄、临床分期、治疗方式等因素的关系。方法：运用流式细胞术对151例患者外周血 T 淋巴细胞亚群及 NK 细胞进行检测。结果：与良性组比较，恶性肿瘤组 CD3＋下降、CD4＋下降极显著（P ＜0．01），CD4＋／CD8＋下降显著（P ＜0．05），CD8＋则略有升高；恶性肿瘤组 CD4＋、CD4＋／CD8＋表现出随临床分期提高逐渐降低的趋势，CD8＋则反之。其中Ⅲ－Ⅳ期 CD8＋、CD4＋／CD8＋较 I 期存在极显著性差异（P ＜0．01）；与未转移组比较，已转移组 CD3＋下降、CD4＋下降显著（P ＜0．05），CD4＋／CD8＋下降极显著（P ＜0．01），CD8＋升高；术后组 CD3＋、CD4＋、CD4＋／CD8＋较未治疗组升高，CD8＋下降，并且 CD4＋／CD8＋升高显著（P ＜0．05）；术后组 CD4＋、CD4＋／CD8＋较放化疗组升高、CD8＋下降，差异均极显著（P ＜0．01）；放化疗组 CD4＋、CD8＋、CD4＋／CD8＋与未治疗组比较差异具有统计学意义（P ＜0．05）。结论：妇科肿瘤患者的免疫功能受到不同程度的抑制，这种抑制与患者年龄、病情进展存在一定的相关性。在肿瘤治疗中解除瘤负荷和保护机体的免疫功能具有同等重要的意义。%Objective:To evaluate the changes of the immune function of gynecology tumor,and observe the rela-tionship between the immune function and age,TNM,treatment,etc.Methods:Peripheral blood T lymphocyte subsets and NK cells of 151 patients were detected by flow cytometry(FCM).Results:Lowers CD3 +,CD4 +(P <0.01)and CD4 +/CD8 + ratio(P <0.05)were detected in blood samples from the malignancies than that from the benign,CD8 +were slightly elevated.CD4 + and CD4 +/CD8 + ratio from the malignancies were negatively correlated with TNM stage,the CD8 + were reverse.There were significant differences of CD8 + and CD4 +/CD8 + ratio(P <0.01)betweenⅢ -Ⅳ period and I period.Compared with the no -metastasis group,CD3 +,CD4 + and CD4 +/CD8 + ratio were de-creased,CD8 + were elevated,which from the transfer group,the differences from CD4 + and CD8 + were significant(P<0.05),and the one from CD4 +/CD8 + ratio was highly significant different(P <0.01).CD3 +,CD4 + and CD4 +/CD8 + ratio from operation group were higher in comparison with that in untreated group,CD8 + was lower,and CD4 +/CD8 + ratio was significantly higher(P <0.05).CD4 + and CD4 +/CD8 + ratio from operation group were significantly higher(P <0.01)than that in chemoradiotherapy group,and CD8 + was significantly lower(P <0.01).The differ-ence of CD4 +,CD8 + and CD4 + /CD8 + ratio between chemoradiotherapy group and untreated group was differ-ent(P <0.05).Conclusion:The immune function in gynecology tumor patients was correlate with patients'age,and disease progression,was inhibited with different degrees.Removing the tumor was as importent as protecting the im-mune function.