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目的:探讨胰腺癌患者冷冻消融治疗前后外周血T细胞亚群和NK细胞及TNF-α水平的变化及临床意义。方法:采用流式细胞术和ELISA法分别测定37例胰腺癌患者冷冻前后外周血T细胞亚群CD3、CD4、CD8和NK细胞及TNF-α的水平,并与健康对照组比较。结果:与对照组相比,患者术前的CD3、CD4、CD4/CD8及NK水平均明显降低,P<0.05,TNF-α水平明显升高,P<0.05;术后10dCD3和CD4及TNF-α水平均无明显变化,P>0.05,而CD4/CD8和NK水平均明显下降,P<0.05;术后30d所有指标的水平与对照组比较均差异无统计学意义,P>0.05。与术前比较,患者术后10d所有指标的水平差异均无统计学意义,P>0.05;而术后30dCD4和NK水平均明显升高,P<0.05,TNF-α水平显著下降,P<0.05。患者性别与所有指标的水平均无关(P>0.05),临床分期及肝转移与CD4、CD4/CD8、NK及TNF-α水平均相关,P<0.05。结论:冷冻消融治疗可增强胰腺癌患者的细胞免疫功能,检测外周血CD4、CD4/CD8和NK及TNF-α水平的变化,有利于胰腺癌患者的疗效和预后评估。
Objective: To investigate the changes and clinical significance of T lymphocyte subsets, NK cells and TNF-α levels in peripheral blood of patients with pancreatic cancer before and after cryoablation. METHODS: Flow cytometry and ELISA were used to determine the levels of T cell subgroups of CD3, CD4, CD8, NK cells and TNF-α in 37 patients with pancreatic cancer before and after freezing, and compared with healthy controls. Results: Compared with the control group, the preoperative levels of CD3, CD4, CD4/CD8, and NK were significantly lower, P<0.05, TNF-α levels were significantly elevated, P<0.05; CD3, CD4, and TNF- There was no significant change in the level of α, P>0.05, but the levels of CD4/CD8 and NK were significantly decreased, P<0.05. There was no significant difference in the level of all indexes 30 days after surgery compared with the control group, P>0.05. Compared with preoperative, there was no statistically significant difference in the level of all indicators on postoperative day 10, P>0.05, and on the 30th day after surgery, the levels of CD4 and NK increased significantly, P<0.05, TNF-α levels decreased significantly, P<0.05 . The gender of the patients was not related to the levels of all indexes (P>0.05). Clinical stage and liver metastasis were related to the levels of CD4, CD4/CD8, NK and TNF-α, P<0.05. Conclusion: Cryoablation therapy can enhance the cellular immune function of patients with pancreatic cancer, and detect the changes of CD4, CD4/CD8, NK and TNF-α levels in peripheral blood, which is beneficial to the efficacy and prognosis evaluation of pancreatic cancer patients.