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目的观察胃癌患者手术前后 T 细胞亚群的变化。方法采用单克隆抗体酶标法对30例胃癌患者手术前后不同时期的 T 细胞亚群即表达于所有 T 细胞的表面分子(CD3)、辅助 T 细胞的表面分子(CIM)、抑制 T 细胞的表面分子(CD8)进行动态检测。结果 (1)胃癌组 CD3、CD4阳性细胞数和 CD4/CD8比值明显低于正常对照组,CD8阳性细胞数高于正常对照组。(2)手术可引起 T 细胞亚群变化,这种变化是可逆的。(3)根治性切除术后免疫功能呈现暂时抑制到逐渐恢复的过程,但低于对照组。(4)未根治性切除术后免疫功能持续低下,CD4/CD8比值倒置,提示预后差。结论开展围手术期 T 细胞亚群动态检测,对了解胃癌患者细胞免疫状态、肿瘤是否转移和评估预后有一定的临床意义,也为胃癌患者手术后采用免疫增强治疗提供了理论依据。
Objective To observe the changes of T cell subsets before and after surgery in patients with gastric cancer. Methods T cell subpopulations in different stages of gastric cancer patients before and after surgery were performed using monoclonal antibody enzyme labeling method. The T cell subsets were expressed on all T cell surface molecules (CD3), surface molecules of helper T cells (CIM), and the surface of suppressor T cells. The molecule (CD8) is dynamically detected. Results (1) The number of CD3 and CD4 positive cells and CD4/CD8 ratio in the gastric cancer group were significantly lower than those in the normal control group. The number of CD8 positive cells was higher in the gastric cancer group than in the normal control group. (2) Surgery can cause changes in T cell subsets, and this change is reversible. (3) The immune function after radical resection showed a temporary inhibition to a gradual recovery, but it was lower than that of the control group. (4) The immune function was not continuous after radical debridement and the ratio of CD4/CD8 was inverted, indicating a poor prognosis. Conclusion The development of perioperative T cell subsets dynamic test has certain clinical significance for understanding the cellular immune status, metastasis and evaluating prognosis of gastric cancer patients. It also provides a theoretical basis for the use of immunopotentiation therapy for gastric cancer patients after surgery.