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目的 研究恶性肿瘤患者围化疗期的免疫状态变化。方法 应用流式细胞术和ELISA分别测定恶性肿瘤患者化疗前后T细胞亚群 ,化疗前NK、B细胞 ,化疗 +放疗后T细胞亚群和血浆可溶性白细胞介素 - 2受体(sIL - 2R)、肿瘤坏死因子 (TNF -α)含量。结果 恶性肿瘤患者化疗前CD3、CD4、CD4/CD8、B细胞水平明显低于正常 ,血浆sIL - 2R、TNF -α、CD8较正常显著增高 ,NK与正常组相比无明显变化。化疗 3周后治疗有效者CD3、CD4、CD4/CD8较化疗前有明显升高 (P <0 .0 1) ,血浆sIL - 2R、TNF -α、CD8较化疗前降低 (P <0 .0 1) ,化疗后CD4、CD8、CD4/CD8接近正常对照组 ;化疗无效者CD3、CD4、CD4/CD8与化疗前相比无明显变化。化疗 +放疗者CD3、CD4、CD4/CD8较治疗前下降明显。恶性肿瘤患者T细胞亚群、sIL - 2R与分期有关。结论 恶性肿瘤患者机体细胞免疫、体液免疫均受到抑制 ,化疗后有效患者全身免疫状况改善 ,化疗无效患者无明显变化 ,化疗 +放疗患者机体免疫进一步受到抑制。
Objective To study the changes of immune status during the chemotherapy in patients with malignant tumors. Methods The levels of T lymphocyte subsets, NK cells, B lymphocytes, T lymphocyte subsets and soluble interleukin - 2 receptor (sIL - 2R) in patients with malignant tumor before and after chemotherapy were determined by flow cytometry and ELISA respectively. , Tumor necrosis factor (TNF-α) content. Results Before chemotherapy, the levels of CD3, CD4, CD4 / CD8 and B cells in patients with malignant tumor were significantly lower than those in normal patients. The levels of plasma sIL - 2R, TNF - α and CD8 in patients with malignant tumor were significantly higher than those in normal patients. After 3 weeks of chemotherapy, the levels of CD3, CD4 and CD4 / CD8 in the treatment-effective group were significantly higher than those before chemotherapy (P <0.01), while the levels of sIL-2R, TNF- 1). After chemotherapy, CD4, CD8 and CD4 / CD8 were close to those of normal control group. There was no significant difference in the levels of CD3, CD4 and CD4 / CD8 before chemotherapy in patients with chemotherapy failure. Chemotherapy + radiotherapy CD3, CD4, CD4 / CD8 decreased significantly than before treatment. T lymphocyte subsets and sIL - 2R in patients with malignant tumor are related to staging. CONCLUSION: The cellular and humoral immunity of malignant tumor patients are inhibited. After chemotherapy, the immune status of effective patients is improved. There is no obvious change in chemotherapy-ineffective patients. The immunity of chemotherapy + radiotherapy patients is further inhibited.