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目的 :研究胃肠癌患者围手术期运用西咪替丁 (CIM)对肿瘤局部免疫反应的影响。方法 :4 9例胃肠癌患者随机分成治疗组 2 5例和对照组 2 4例 ,前者围手术期服用CIM ,后者不用此药。两组患者均行根治术。常规HE染色 ,取肿瘤边缘组织 ,每高倍视野下≥ 10 0个淋巴细胞称为反应明显 ,<10 0个淋巴细胞称为反应不明显。结果 :镜下观察发现 2 5例治疗组中 17例 ( 68% )出现明显淋巴细胞浸润反应 ,2 4例对照组中有 6例 ( 2 5% )出现明显淋巴细胞浸润反应 (P <0 0 1)。治疗组的淋巴细胞反应阳性率与TNM分期呈正相关 ,对照组中淋巴细胞反应阳性率与TNM分期呈负相关 ,两组患者淋巴细胞反应阳性率在Ⅲ、Ⅳ期有显著性差异。结论 :CIM拮抗肿瘤局部组织胺的免疫抑制作用 ,提高淋巴细胞反应 ,可能是CIM提高肿瘤患者生存期的机理之一。
Objective: To study the effect of cimetidine (CIM) on the local immune response in patients with gastrointestinal cancer during perioperative period. Methods: Forty-nine patients with gastrointestinal cancer were randomly divided into treatment group (n = 25) and control group (n = 24). The former received perioperative CIM while the latter did not receive this drug. Two groups of patients underwent radical surgery. Conventional HE staining, taking the tumor marginal tissue, each high power field under the ≥ 10 0 lymphocytes known as the reaction was significantly less than 10 0 lymphocytes known as the reaction was not obvious. RESULTS: In the microscopic examination, significant lymphocytic infiltration was observed in 17 (68%) of the 25 treatment groups and in 6 of 24 control subjects (25%) (P <0 0 1). The positive rate of lymphocyte reaction in the treatment group was positively correlated with the TNM stage. The positive rate of lymphocyte reaction in the control group was negatively correlated with the TNM stage. The positive rates of lymphocyte reaction in the two groups were significantly different between stage Ⅲ and stage Ⅳ. Conclusion: CIM can inhibit the histamine amyloid immunosuppression and increase lymphocyte reaction in CML patients, which may be one of the mechanisms by which CIM can improve the survival of cancer patients.