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目的研究高海拔地区进展期胃癌（AGC）患者脾脏的免疫状态及胃癌根治术合并切脾患者的免疫功能。方法分别对32例AGC患者不同部位，不同时期的T细胞亚群（CD3、CD4、CD8、CD4／CD8）、循环免疫复合物（CIC）和补体（CH50、C3、C4）值进行动态检测。结果（1）AGC患者的外周血淋巴细胞（PBL），脾静脉血淋巴细胞（SVL）的CD3、CD4、CD8、CD4／CD8细胞值和补体CH50、C3、C4值均比正常人明显降低；CIC值均高于正常人。（2）AGC患者PBL的CD4、CD4／CD8细胞值较SVL值低。（3）无论施行合并切牌的胃癌扩大根治术（R3术）或未切脾的胃癌根治术（R2术）后，患者的CD3、CD4、CD4／CD8细胞比值明显升高，CD8细胞值相对减低，而CIC值明显下降。（4）无论在术后短期（10-15天）或较长期（1－2年）作R2与R3术的患者T细胞亚群值间均无明显差异。结论高原地区进展期胃癌能明显削弱患者的免疫功能；切除肿瘤有益于增强机体抗瘤能力，提高患者的免疫功能活性；行民术后并未对患者的免疫状态造成明显不良影响。
Objective To study the immune status of spleen in patients with advanced gastric cancer (AGC) at high altitude and the immune function of patients with radical gastrectomy combined with splenectomy. Methods T cell subsets (CD3, CD4, CD8, CD4/CD8), circulating immune complexes (CIC) and complement (CH50, C3, C4) were dynamically detected in 32 patients with AGC. Results (1) The values of CD3, CD4, CD8, CD4/CD8 and complement CH50, C3 and C4 in peripheral blood lymphocytes (PBL) and spleen venous blood lymphocytes (SVL) of AGC patients were significantly lower than those in normal controls. The CIC value is higher than normal people. (2) The CD4, CD4/CD8 cell values of PBL in AGC patients are lower than the SVL values. (3) The ratio of CD3, CD4, and CD4/CD8 cells was significantly higher in patients undergoing radical resection of gastric cancer (R3 surgery) or unsliced radical gastrectomy (R2 surgery) without combined sputectomy Decreased while the CIC value decreased significantly. (4) There was no significant difference in T cell subsets between patients undergoing R2 and R3 short-term (10-15 days) or longer (1-2 years). Conclusions Advanced gastric cancer in plateau area can significantly weaken the immune function of patients; removal of tumors is beneficial to enhance the body’s anti-tumor ability and improve the patient’s immune function activity; the patients did not have significant adverse effects on the patient’s immune status.