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目的 动态观察卵巢癌患者免疫功能的变化。方法 采用3 H掺入法测定外周血淋巴细胞增殖实验 ;红细胞免疫用红细胞C3b受体花环率 (RC3bRR)、红细胞免疫复合物花环率 (RICR)、红细胞肿瘤花环率 (E TR)测定。结果 手术前恶性卵巢癌组与良性组、正常对照组相比 ,外周血淋巴细胞增殖指数 (SI)、RC3bRR、E TR明显下降 (P <0 .0 5 ) ,RICR明显升高 (P <0 .0 5 )。恶性组手术后各项指标与术前相比 ,除RICR明显下降外 ,其他均有明显升高 ,并有显著差异 (P均 <0 .0 5 )。化疗第一疗程后SI、RC3bRR、E TR与术前、后比较 ,均有显著下降 (P <0 .0 5 ) ,但RICR显著升高。而且组织分化程度越差 ,SI、RC3bRR、E TR越有不同程度下降 ,RICR明显升高。卵巢上皮癌和卵巢转移癌SI、RC3bRR、E TR较恶性生殖细胞肿瘤及性索间质瘤明显降低 (P <0 .0 5 ) ,RICR明显升高 (P <0 .0 5 )。Ⅰ、Ⅱ期卵巢癌患者较Ⅲ、Ⅳ期的各项免疫指标差异显著 (P <0 .0 5 )。结论 卵巢癌的发生可能与循环血中淋巴细胞及红细胞的免疫功能有关。卵巢癌的治疗强调手术治疗为主 ,应在手术后早期应用免疫增强剂。
Objective To observe the changes of immune function in patients with ovarian cancer. Methods The proliferation of peripheral blood lymphocytes was assayed by 3H-incorporation method. The erythrocyte immune function was determined by RC3bRR, RICR and ETR of erythrocyte C3b receptor. Results Compared with the benign group and the normal control group, the peripheral blood lymphocyte proliferation index (SI), RC3bRR and E TR were significantly decreased in the preoperative malignant ovarian cancer group (P <0.05), and RICR was significantly increased (P <0 .0 5). The indexes of malignant group were significantly higher than those before operation except RICR, which were significantly different (all P <0.05). After the first course of chemotherapy, SI, RC3bRR and E TR were significantly decreased compared with before and after chemotherapy (P <0.05), but RICR was significantly increased. And the worse the degree of tissue differentiation, SI, RC3bRR, E TR more varying degrees of decline, RICR was significantly higher. The levels of SI, RC3bRR and E TR in malignant ovarian epithelial carcinoma and ovarian metastatic carcinoma were significantly lower than those in malignant germ cell tumor and sex cord stromal tumor (P <0.05), and RICR was significantly increased (P <0.05). Patients with stage I and stage II ovarian cancer showed significantly different immunological parameters from stage III and stage IV (P <0.05). Conclusion The occurrence of ovarian cancer may be related to the immune function of lymphocytes and erythrocytes in circulating blood. Ovarian cancer treatment emphasizes surgical treatment should be early after the application of immune enhancers.