西咪替丁提高胃肠癌区域淋巴细胞反应的临床研究.docVIP

???? 西咪替丁提高胃肠癌区域淋巴细胞反应的临床研究 ???? ???? 【摘要】　目的：研究胃肠癌患者围手术期运用西咪替丁(CIM)对肿瘤局部免疫反应的影响。方法：49例胃肠癌患者随机分成治疗组25例和对照组24例，前者围手术期服用CIM，后者不用此药。两组患者均行根治术。常规HE染色，取肿瘤边缘组织，每高倍视野下≥100个淋巴细胞称为反应明显，＜100个淋巴细胞称为反应不明显。结果：镜下观察发现25例治疗组中17例(68%)出现明显淋巴细胞浸润反应，24例对照组中有6例(25%)出现明显淋巴细胞浸润反应(P＜0.01)。治疗组的淋巴细胞反应阳性率与TNM分期呈正相关，对照组中淋巴细胞反应阳性率与TNM分期呈负相关，两组患者淋巴细胞反应阳性率在Ⅲ、Ⅳ期有显著性差异。结论：CIM拮抗肿瘤局部组织胺的免疫抑制作用，提高淋巴细胞反应，可能是CIM提高肿瘤患者生存期的机理之一。【关键词】　西咪替丁；胃肠肿瘤；淋巴细胞反应中分类号：R735；R73-36　　　　文献标识码：A　　　　文章编号：1009-4571(2000)01-0031-03 Cimetidine enhances local lymphocytes response to gastrointestinal cancer:results of a clinical trail 　WANG Kun　YANG Guo-liang　YUAN Hong-yin　et al（Department of Oncology,The Second Affiliated Hospital of Hubei Medical University,Wuhan 430071） 【Abstract】　Objective：To study the effects of perioperative CIM application on the local immune response in gastrointestinal cancer patients.Methods：49 gastrointestinal cancer were randomized into treatment group which took CIM in the perioperative period,and control group which did not take the drug.They were treated by radical resection of gastrointestinal cancer.The resected specimens were sectioned and stained with hemotoxylin and eosin.A lymphocyte density of more than 100 cells per high-power field (approximately 50% of the tumor/tissue interface) was considered a positive response.Results：A positive lymphocyte response was observed in 17 of 25 (68%) in treatment group and 6 of 24 (25%) in control group (P＜0.01).Lymphocytes response and TNM classification were in reverse correlation trend in control group and positive correlation trend in treatment group.There is significant difference of positive lymphocyte response in Ⅲ and Ⅳ period.Conclusions：Cimetidine enhances lymphocyte response by inhibiting the immunosuppressive effects of histamine within local tumor.It is the possible reason for the improvement of patient survival.【Key words】　cimetidine;gastrointestinal cancer;lymphocytes reponse 　　研究西咪替丁(CIM)对胃癌和结直肠癌患者局部免疫反应的影响，并试解释其延长生存期的作用机制，从而为胃肠癌患者的综