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高原地区进展期胃癌患者脾脏免疫状态与手术治疗的临床研究

A Clinical Study of Surgical Treatment and Immunologic Functions of Spleen with Advanced Gastric Cancer in Plateau

  • 摘要: 目的 研究高海拔地区进展期胃癌(AGC)患者脾脏的免疫状态及胃癌根治术合并切脾患者的免疫功能。 方法 分别对32例AGC患者不同部位,不同时期的T细胞亚群(CD3、CD4、CD8、CD4/CD8)、循环免疫复合物(CIC)和补体(CH50、C3、C4)值进行动态检测。 结果 (1)AGC患者的外周血淋巴细胞(PBL),脾静脉血淋巴细胞(SVL)的CD3、CD4、CD8、CD4/CD8细胞值和补体CH50、C3、C4值均比正常人明显降低;CIC值均高于正常人。(2)AGC患者PBL的CD4、CD4/CD8细胞值较SVL值低。(3)无论施行合并切牌的胃癌扩大根治术(R3术)或未切脾的胃癌根治术(R2术)后,患者的CD3、CD4、CD4/CD8细胞比值明显升高,CD8细胞值相对减低,而CIC值明显下降。(4)无论在术后短期(10-15天)或较长期(1-2年)作R2与R3术的患者T细胞亚群值间均无明显差异。 结论 高原地区进展期胃癌能明显削弱患者的免疫功能;切除肿瘤有益于增强机体抗瘤能力,提高患者的免疫功能活性;行民术后并未对患者的免疫状态造成明显不良影响。

     

    Abstract: Objective To study immunologic funtions of the spleen on patients with advanced gastric cancer (AGC) and to study immunologic funtions on patients by gastrectomy and splenectomy in plateau. Methods :The levels of T cell subgroups (CD3,CD4,CD8,CD4/CD8) circulatory immune complexes(CIC) and complenmentin(CH50,C3,C4) in 32 cases with AGC were measured in different part and stage Results(1) The cell levels of CD3,CD4,CD8,CD4/CD8 in peripheral blood lymphocytes(PBL) and spleen vein blood lymphocytes (SVL)and the levels of CH50,C3,C4 on patients with AGC were less than controls one's,but the levels of CIC were higher than controls (2) The levels of CD4,CD4/CD8 in PBL were less than ones in SVL on patients with AGC.(3) Whether by gastrectomy and splenectomy (R3) or only gastrectomy (R2) the levels of CD3, CD4, CD4/CD8 increase remarkly the levels of CD8 decrease but the levels of CIC decrease remarkbly on patients with AGC.(4) During short time (10-15 days) or long time(1-2 years) the levels of T cell subgroups were not different on patients by R3 or R2. Conclusion The immunologic functions of patients were decreased by advanced gastric cancer the functions of resisting cancer were increased also the immunologic functions were improved the immunologic funcitons wrer not injureed by gastrectomy and splenectomy.

     

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