论文部分内容阅读
目的探索术中淋巴化疗对食管癌患者术后免疫功能的影响。方法前瞻性纳入2013年3~10月于华西医院胸外科接受食管癌术中淋巴化疗的病例及同期未接受淋巴化疗的食管癌手术病例。纳入患者分为紫杉醇淋巴化疗组、氟尿嘧啶淋巴化疗组及未接受淋巴化疗的对照组。比较淋巴化疗组与对照组患者术前、术后第3 d和第7 d外周血体液和细胞免疫学代表性指标的变化。共纳入分析病例37例,男25例,女12例;年龄42~76(61.89±7.95)岁。紫杉醇淋巴化疗组15例,氟尿嘧啶淋巴化疗组15例,对照组7例。结果 3组术后所有免疫学指标均有不同程度降低。淋巴化疗组与对照组相比,免疫球蛋白浓度下降差异无统计学意义(P>0.05),CD8+T细胞计数在淋巴化疗组术后恢复快,CD3+T细胞计数在氟尿嘧啶淋巴化疗组恢复较快。结论淋巴化疗有利于食管癌患者术后T细胞的细胞毒作用的恢复,对体液免疫可能无促进作用。
Objective To explore the effect of intraoperative lymphatic chemotherapy on postoperative immune function in patients with esophageal cancer. Methods The prospectively enrolled cases of intraoperative lymphatic chemotherapy of esophageal cancer undergoing thoracic surgery in West China Hospital from March to October 2013 and the cases of esophageal cancer who did not receive lymphatic chemotherapy in the same period. The patients were divided into paclitaxel lymphoid chemotherapy group, fluorouracil lymphoid chemotherapy group and non-lymphoma control group. The changes of the representative indices of humoral and cellular immunity in peripheral blood lymphocytes in the lymphoid group and the control group were compared before and 3 days and 7 days after operation. A total of 37 cases were analyzed, including 25 males and 12 females, aged from 42 to 76 (61.89 ± 7.95 years). 15 cases of paclitaxel lymphoid chemotherapy group, 15 cases of fluorouracil lymphoid chemotherapy group and 7 cases of control group. Results All the three immunological indexes decreased after operation. There was no significant difference in the immunoglobulin concentration between the lymphatic chemotherapy group and the control group (P> 0.05). CD8 + T cell count recovered rapidly in the lymphatic chemotherapy group and CD3 + T cell count was restored in the fluorouracil lymphatic chemotherapy group Faster. Conclusion Lymphatic chemotherapy is beneficial to the recovery of postoperative T cells cytotoxicity in esophageal cancer patients, and may not promote humoral immunity.