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目的:探讨T3期大肠癌患者新辅助化疗与手术前后外周血T细胞亚群免疫功能的变化规律。方法:入组56例T3期大肠癌患者,以奥沙利铂为主的新辅助联合化疗后行根治性手术,采用流式细胞术检测新辅助化疗前1天、术后第7天及术后14天外周血中T细胞亚群免疫功能(CD3+、CD3+CD4+、CD3+CD8+、CD4+/CD8+)的变化规律。并与50例健康对照组比效。结果:T3期大肠癌患者新辅助化疗前外周血T细胞亚群免疫功能低于正常对照组,但差异无统计学意义(P>0.05);T3期大肠癌患者新辅助化疗及手术后7天外周血T细胞亚群免疫功能明显低于未治疗前患者,差异有统计学意义(P<0.01);T3期大肠癌患者新辅助化疗及手术后14天外周血T细胞亚群免疫功能稍低于未治疗前患者,但差异无统计学意义(P>0.05)。结论:T3期大肠癌患者细胞免疫功能低下,经新辅助化疗与手术后1周细胞免疫功能进一步下降,但术后2周细胞免疫功能已恢复接近至治疗前水平。提示T3期大肠癌患者经新辅助化疗与手术治疗前后免疫功能呈U形的变化规律,能为临床根据细胞免疫功能更好地进行大肠癌的综合治疗提供理论依据。
Objective: To investigate the changes of T cell subsets immune function in neoadjuvant chemotherapy and before and after operation in patients with T3 colorectal cancer. Methods: Fifty-six patients with stage T3 colorectal cancer were enrolled. Patients undergoing neoadjuvant chemotherapy combined with oxaliplatin were treated with radical surgery. Flow cytometry was used to detect neoadjuvant chemotherapy one day before surgery, The changes of immune function (CD3 +, CD3 + CD4 +, CD3 + CD8 +, CD4 + / CD8 +) of T lymphocyte subsets in peripheral blood after 14 days. And with 50 cases of healthy control group. Results: The immune function of peripheral blood T lymphocyte subsets in patients with T3 colorectal cancer before neoadjuvant chemotherapy was lower than that of the normal control group, but the difference was not statistically significant (P> 0.05). In T3 patients with neoadjuvant chemotherapy and 7 days after surgery The immune function of T lymphocyte subsets in peripheral blood was significantly lower than that of untreated patients (P <0.01). The immune function of peripheral blood T lymphocyte subsets in T3 patients with neoadjuvant chemotherapy and 14 days after operation was slightly lower Before untreated patients, but the difference was not statistically significant (P> 0.05). CONCLUSION: The cellular immune function of T3 patients with colorectal cancer is low. Neoadjuvant chemotherapy and cellular immune function decrease 1 week after surgery. However, the cellular immune function recovered to the level before treatment two weeks after operation. Tip T3 patients with colorectal cancer by neoadjuvant chemotherapy and surgery before and after the immune function was U-shaped changes in the law, can provide a theoretical basis for clinical treatment of colorectal cancer based on cellular immune function better.