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目的探讨结直肠癌患者外周血前列腺素E2(PGE2)和血清可溶性白细胞介素-2受体(sIL-2R)在手术前后的动态变化及临床意义。方法 61例结直肠癌患者按是否有转移分成2组,无远处转移组46例,远处转移组15例,其中根治性切除41例,姑息性切除11例,剖腹探查9例,对照组为健康体检者。分别检测患者手术前后外周血PGE2s、IL-2R和CD4+、CD8+含量。结果结直肠癌患者术前外周血PGE2和sIL-2R水平明显升高,同时白细胞介素2(IL-2)水平和CD4+/CD8+值降低,IL-2与sIL-2R和PGE2呈显著负相关,手术切除原发肿瘤后PGE2和sIL-2R水平显著下降,同时IL-2水平和CD4+/CD8+值升高,其中,根治组和对照组相比术后差异无统计学意义,姑息性切除组和剖腹探查组术后外周血PGE2和sIL-2R水平仍高于正常。结论 PGE2和sIL-2R参与了结直肠癌患者术前存在的免疫抑制过程,结直肠癌患者外周血PGE2和sIL-2R水平动态检测可视为结直肠癌根治术后是否复发或转移的辅助指标。
Objective To investigate the changes and clinical significance of prostaglandin E2 (PGE2) and soluble interleukin-2 receptor (sIL-2R) in patients with colorectal cancer before and after operation. Methods Sixty-one patients with colorectal cancer were divided into two groups according to whether there was metastasis or not. There were 46 cases without distant metastasis and 15 cases with distant metastasis. Among them, radical resection was performed in 41 cases, palliative resection in 11 cases, laparotomy in 9 cases and control group For the health examination. Peripheral blood PGE2s, IL-2R and CD4 +, CD8 + levels were measured before and after the operation. Results The levels of PGE2 and sIL-2R in peripheral blood of patients with colorectal cancer were significantly increased at the same time. The level of IL-2 and CD4 + / CD8 + were also decreased. The levels of IL-2 and sIL-2R and PGE2 were negatively correlated , The levels of PGE2 and sIL-2R were significantly decreased after surgical resection of primary tumor, while IL-2 level and CD4 + / CD8 + value increased. There was no significant difference between the radical treatment group and the control group after operation. Palliative resection group And laparotomy group postoperative peripheral blood PGE2 and sIL-2R levels were still higher than normal. Conclusions PGE2 and sIL-2R are involved in the preoperative immunosuppressive process in patients with colorectal cancer. The dynamic changes of PGE2 and sIL-2R levels in peripheral blood of patients with colorectal cancer can be considered as secondary indicators of recurrence or metastasis after radical resection of colorectal cancer.