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目的研究大肠癌患者围手术期的免疫状态。方法应用APAAP夹心法ELISA和比色法分别测定大肠癌患者手术前后T细胞亚群变化、血浆可溶性白介2受体(sIL-2R)及一氧化氮(NO)和癌组织的sIL-2R、NO含量。结果大肠癌患者手术前CD3、CD4细胞、CD4/CD8比值和血浆NO水平明显低于正常,血浆sIL-2R、CD8细胞较正常显著增高,肿瘤切除后3周左右CD3、CD4细胞、CD4/CD8和血浆NO较术前有明显升高,sIL-2R和CD8细胞较术前降低,术后T细胞亚群、sIL-2R和NO水平接近正常对照组;大肠癌患者T细胞亚群、sIL-2R和NO与大肠癌Dukes临床分期有关;大肠癌组织中sIL-2R、NO含量显著高于癌旁组织。结论恶性肿瘤患者机体免疫受到抑制,切除肿瘤后全身免疫机能状况改善,测定肿瘤患者的T细胞亚群和血浆sIL-2R、NO能够较好地反映机体的免疫状况,并可为判断大肠癌病情和指导临床治疗提供有价值的参考资料。
Objective To study the perioperative immune status of colorectal cancer patients. Methods APAAP sandwich ELISA and colorimetry were used to determine the change of T lymphocyte subsets, soluble interleukin 2 receptor (sIL-2R) and nitric oxide (NO), and sIL-2R in cancer tissue before and after surgery. NO content. Results The preoperative CD3, CD4, CD4/CD8 and plasma NO levels were significantly lower than normal in patients with colorectal cancer. Plasma sIL-2R and CD8 cells were significantly higher than normal, with CD3, CD4 cells, and CD4/CD8 approximately 3 weeks after tumor resection. Plasma NO levels were significantly higher than those before surgery, and sIL-2R and CD8 cells were lower than before surgery. Postoperative T-cell subsets, sIL-2R, and NO levels were similar to normal controls; T-cell subsets and sIL- 2R and NO were related to the clinical stage of Dukes in colorectal cancer. The levels of sIL-2R and NO in colorectal cancer tissue were significantly higher than those in adjacent tissues. Conclusion The immune system of patients with malignant tumors was inhibited. After the tumors were removed, the immune function was improved. The determination of T lymphocyte subsets and plasma sIL-2R, NO in tumor patients can reflect the body’s immune status and can be used to judge the condition of colorectal cancer. And provide valuable reference materials for guiding clinical treatment.