辅助化疗对肿瘤患者体液免疫的影响

摘要

Objective To investigate the changes of B lymphocyte count and immunoglobulin of patients with cancer during chemotherapy.Methods Six patients with colorectal cancer and 24 patients with breast cancer in this study were enrolled at general surgery of xuanwu hospital between March 2010 to March 2011.They received adjuvant chemotherapy.The chemotherapy regimes were determined by desease.Blood test results were obtained on the frist day of each cycle,and flow cytometry and immunoglobulin results were obtained on the first day of cycles 1 (before chemotherapy),4 or 5 (in the chemotherapy),8 (after chemotherapy) day.Results B lymphocyte counts were 0.05 ±0.04,0.10 ±0.04,0.04 ±0.04 after treatment of EC and in the chemotherapy of TAC and after treatment of TAC.There were significant differences of IgG before and after treatment of TC,TAC,AC-T chemotherapy (909 ±305 vs 1120 ±256,772 ± 153 vs 1085 ±205,1038 ±275 vs 1297 ±348,respectively),IgA before and after treatment of TAC,AC-T chemotherapy (214 ±88 vs 266 ±91,273 ± 148 vs 324 ± 191,respectively),and IgM before and after treatment of EC,TAC,AC-T,FOLFOX or xelox (112 ± 62 vs 137 ± 73,68 ± 18 vs 103 ± 29,68 ±20 vs 87 ±22,101 ±40 vs 121 ±51,respectively).Conclusion The humoral immunity system is injured after chemotherapy.%目的 探讨辅助化疗对肿瘤患者外周血B淋巴细胞计数及免疫球蛋白的影响.方法 研究对象为2010年3月至201 1年3月在首都医科大学宣武医院行肿瘤根治术并行辅助化疗的6例结直肠癌患者和24例乳腺癌患者,结直肠癌患者采用FOLFOX或XELOX治疗,乳腺癌患者采用紫杉为主方案(TC方案,6例)、蒽环为主方案(EC或CEF方案,6例)、蒽环与紫杉联合方案(TAC,6例)、蒽环与紫杉续贯方案(AC-T,6例).患者每个化疗周期前均进行血常规检查,同时在第1周期前(化疗前)、第4或5周期前(化疗中)、第8周期(化疗后)均进行外周血流式细胞检测及免疫球蛋白定量检测.结果 EC方案化疗后及TAC方案化疗中、化疗后B淋巴细胞分别为0.05 ±0.04、0.10±0.04、0.04±0.04,与治疗前(0.21 ±0.15、0.19 ±0.13)比较,差异均有统计学意义(P＜0.05或P＜0.01).TC、TAC、AC-T化疗前后IgG差异有统计学意义(分别为909±305比1120±256,772±153比1085±205,1038±275比1297±348,P＜0.05或P＜0.01),TAC、AC-T化疗前后IgA差异有统计学意义(分别为214±88比266 ± 91,273±148比324±191,P＜0.05或P＜0.01),EC、TAC、AC-T、FOLFOX或XELOX化疗前后IgM差异有统计学意义(分别为112 ±62比137 ±73,68±18比103 ±29,68 ±20比87±22,101 ±40比121 ±51,P＜0.05或P＜0.01).结论 化疗使肿瘤患者体液免疫功能受损.