放疗前后食管癌患者红细胞免疫功能和T淋巴细胞亚群的变化

摘要

目的：研究放疗前后食管癌患者红细胞免疫功能及T淋巴细胞亚群的变化。方法以68例食管癌患者为研究对象（病例组），另外选取健康献血者40例作为对照组。以流式细胞仪检测病例组患者放疗前、接受6周放疗后及对照组血清中T细胞亚群水平，使用受体黏附法检测红细胞免疫功能。结果病例组患者治疗前红细胞免疫功能、血清T细胞亚群水平均显著低于对照组（均P＜0.05），红细胞免疫复合物花环（RBC- ICR）高于对照组（P＜0.01）；放疗后1周，病例组的CD4＋T细胞比例、肿瘤红细胞花环（DTER）、红细胞C3b受体花环（RBC- C3bRR）进一步下降，而CD8＋T细胞比例明显升高，CD4＋/CD8＋比值降低；同放疗前比较均有统计学差异（均P＜0.05）；放疗后3个月病例组CD4＋T细胞比例、DTER、RBC- C3bRR逐步升高，而CD8＋T细胞比例及RBC- ICR逐渐下降，CD4＋/CD8＋比值升高，同放疗前及放疗后1周比较均有统计学差异（均P＜0.05）。结论食管癌患者红细胞免疫功能及T淋巴细胞亚群水平低下，放疗刚结束时，细胞免疫抑制作用为主导，放疗结束3个月后，红细胞免疫功能逐渐改善、T淋巴细胞亚群逐渐恢复。放疗可有效减少肿瘤负荷，改善患者红细胞免疫及T淋巴细胞功能。%Objective To investigate the dynamic changes on erythrocyte immune function and T- lymphocyte sub-groups in patients with esophageal cancer (EC) after radiotherapy. Methods Sixty eight patients with esophageal cancer under-went radiotherapy for 6 weeks. T- cel subsets in peripheral blood were detected by flow cytometry and erythrocyte immune complex wreath (RBC- ICR) was measured by adhesion method in patients before and after radiotherapy. Forty healthy subjects served as controls. Results The erythrocyte immune function and T cel subset in EC patients before radiotherapy were significantly lower and erythrocyte immune complex wreath(RBC- ICR) was higher than those in controls(P<0.05 or 0.01). One week after the treatment, CPT percentage of CD4+cel s, tumor RBC wreath of red blood cel C3b receptor(DTER) (RBC- C3bRR) percentage were declined further, CD8+cel s increased and CD4+/CD8+ratio decreased significantly, compared to those before radiotherapy (al P<0.05). Three months after radiotherapy the CD4+cel s percentage, DTER, RBC- C3bRR escalated, CD8+cel percentage and RBC- ICR gradual y declined, CD4+/CD8+ratio increased, compared to those before radiotherapy and 1 week after radiotherapy (P<0.05). Conclusion Red cel immune function and T lymphocyte levels in patients with esophageal cancer are low, which can be gradual y improved after radiotherapy.