结肠癌根治术后腹腔热化疗对T淋巴细胞亚群及细胞因子的影响.DOCVIP

临床医学论文-结肠癌根治术后腹腔热化疗对T淋巴细胞亚群及细胞因子的影响 ???????????? 作者：胡敏超 方万强 余健雄 吴瑞景 付春利 【摘要】? 目的：探讨腹腔热化学治疗对机体细胞免疫水平的影响。方法：将135例结肠癌根治性切除术后分为A,B两组治疗。A组65例，采用卡铂、5Fu以及丝裂霉素分次溶入加热至45～50℃的生理盐水中腹腔注射；B组65例将上述化疗药物溶入常温生理盐水中腹腔注射，C组62例为健康正常对照组且未行腹腔灌注化疗。分别观察3组病例外周血T淋巴细胞亚群和细胞因子（IL4与IFNγ）的变化。结果：A组热化疗后15 d时，CD4+水平较术后第7天明显增加(t=2.32，P≤0.05)，CD8+水平明显低于B组同期水平(t=3.00，P≤0.05)，IL4水平较术后第7天明显下降(t=2.65，P≤0.05)，而IFNr水平明显增加（t=2.70，P≤0.05）。CD4＋百分比与IFNr水平正相关，CD8＋百分比与IL4水平正相关。结论：结肠癌根治性切除术后热化疗，在杀灭肿瘤细胞的同时，可诱导机体产生抗肿瘤的细胞免疫应答。 【关键词】? 结肠肿瘤 热疗；化学治疗；细胞免疫 ??? Abstract? Objective: To investigate the effect of intraperitoneal thermochemotherapy on Tlymphocyte subsets and cytokine after radical resection of colon cancer. Methods: A total of 135 cases of colon cancer were divided into group A and B. Group A(65 cases) were treated with carboplatin, 5Fu and mitomycin which were dissolved respectively with 45℃50℃ normal saline and injected into abdomen cavity after radical resection, and Group? B were treated with above mentioned drugs which were soluted with normal saline of normal temperature and injected into the abdominal cavity after radical resection. And there were 62 cases of healthy individuals as control (group C). The level of Tlymphocyte subsets and cytokine were explored in these groups. Results: In group A at 15 day after thermochemotherapy, the level of CD4+? Tlymphocyte subsets increased significantly(t=2.32,P≤0.05), CD4+? Tlymphocyte subsets decreased significantly (t=3.00,P≤0.05), the level of IL4 decreased(t=2.65,P≤0.05) but IFNr increased significantly(t=2.70, P≤0.05). The percentage of CD4+T lymphocyte subsets was positively coherent with the level of IFNr, and so was the percentage of CD8+T lymphocyte subsets with the level of IL4. Conclusion: Intraperitoneal thermochemotherapy after radical resection of colon cancer can not only eradicate disseminated tumor cells in abdomen but also induce tumorspecific cellular immunity. ??? Key words?? Colon neoplasm； Thermotherapy； Chemotherapy； Cel