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目的探讨消化系癌血清微量元素与Ｔ细胞亚群关系的临床意义．方法用原子吸收分光光度法测定食管癌３１２例和健康人１００例血清Ｚｎ，Ｃｕ，Ｆｅ，Ｍｎ，Ｃａ．４８例癌患者和健康人外周血Ｔ细胞亚群用间接免疫荧光法测定．结果消化系癌患者血清中Ｃｕ含量，Ｃｕ／Ｚｎ比，ＣＤ８＋显著高于健康人（Ｐ＜００１）；Ｚｎ，Ｃａ含量，ＣＤ３＋，ＣＤ４＋，ＣＤ４＋／ＣＤ８＋比值明显低于健康人（Ｐ＜００５～Ｐ＜００１）；Ⅲ～Ⅳ期及转移癌患者Ｃｕ含量，Ｃｕ／Ｚｎ比，ＣＤ８＋明显高于Ⅰ～Ⅱ期癌患者（Ｐ＜００５～Ｐ＜００１）．直线相关分析表明：血清Ｃｕ，Ｃｕ／Ｚｎ比值与ＣＤ４＋，ＣＤ４＋／ＣＤ８＋比成负相关，Ｚｎ与ＣＤ４＋／ＣＤ８＋比成正相关（Ｐ＜００５）．多因素Ｌｏｇｉｓｔｉｃ回归分析表明，Ｃｕ，Ｃｕ／Ｚｎ比升高，发生消化系癌的相对危险度升高；Ｚｎ，Ｃａ含量升高，发生消化系癌相对危险度降低．结论对消化系癌患者适量补Ｚｎ，调节和改善宿主抗肿瘤免疫力；Ｃｕ／Ｚｎ比对消化系癌阳性诊断率为７０％，特异性为７３％．因此，Ｃｕ／Ｚｎ值可做为消化系癌的一项诊断指标，并对从高危人群中筛检消化系癌患者有一定的意义
Objective To explore the clinical significance of the relationship between serum trace elements and T cell subsets in digestive cancer. Methods The serum levels of Zn, Cu, Fe, Mn, Ca in 312 cases of esophageal cancer and 100 cases of healthy persons were determined by atomic absorption spectrophotometry. T-cell subsets in peripheral blood of 48 cancer patients and healthy individuals were measured by indirect immunofluorescence assay. Results The serum Cu, Cu/Zn ratio and CD8+ in patients with digestive cancer were significantly higher than those in healthy people (P<0.01). The levels of Zn, Ca, CD3+, CD4+ and CD4+/CD8+ were significantly lower than those in healthy people (P< 005-P<001); Cu, Cu/Zn ratio, and CD8+ in patients with stage III-IV and metastatic cancer were significantly higher than those in stage I-II cancer (P<005-P<001) . Linear correlation analysis showed that serum Cu, Cu/Zn ratio was negatively correlated with CD4+, CD4+/CD8+ ratio, and Zn was positively correlated with CD4+/CD8+ ratio (P<005). Multivariate logistic regression analysis showed that the relative risk of digestive cancer increased with the increase of Cu and Cu/Zn ratios; the Zn and Ca levels increased and the relative risk of digestive cancer decreased. Conclusion The appropriate amount of Zn in patients with digestive system cancer can regulate and improve the host anti-tumor immunity. The positive rate of Cu/Zn ratio for digestive cancer is 70%, and the specificity is 73%. Therefore, the value of Cu/Zn can be used as a diagnostic indicator for digestive cancer, and it has certain significance for the screening of patients with digestive cancer from high-risk populations.