肺癌患者化疗前后IL-2、SIL-2R、T细胞亚群和红免指标的动态观察及临床评估

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目的 :探讨原发性肺癌患者化疗前后血清 IL - 2、SIL - 2 R水平 ,外周血 T细胞亚群和红细胞免疫的变化及在肺癌发生、发展的临床意义。方法 :对病理确诊的 2 5例肺癌患者进行 TNM分期、对 NSCL C患者用 MEP方案、对 SCL C患者用 EP方案化疗 ,治疗前后用抗体夹心法检测 IL - 2、SIL - 2 R水平 ,采用 SPA菌体花环双标记法检测 T细胞亚群 ,按郭峰法检测红细胞免疫指标。并以 2 0例健康献血员为对照以探讨上述指标动态变化与肺癌发生发展的关系。结果 :1化疗前肺癌患者 IL - 2水平显著低于对照 ,SIL - 2 R表达显著高于对照 ,化疗后 IL - 2明显回升 ,SIL - 2 R明显下降 ;但仍与对照有显著差异。进而分析 IL - 2水平与 SIL - 2 R含量之间存在高度负相关。 2化疗前肺癌患者CD3、CD4、CD4/ CD8显著低于对照 ,CD8则显著高于对照 ,化疗后上述指标改善呈相对应负性改变 ,CD4/ CD8较化疗前有显著差异。但除 CD8外 ,余均仍低于对照。红免指标 RBC- C3b RR与 RBC- ICR分别显著低于与高于对照 ,化疗后虽有改善 ,但与对照相比 ,仍有显著差异。进而分析显示 CD4/ CD8比值与 RBC- C3b RR间呈高度正相关性。结论 :肺癌患者有多种免疫功能紊乱 ,化疗前后的动态检测有助于对肺癌的发生、发展、疗效、预后作出参考性评介 ,也为 Objective: To investigate the changes of serum IL - 2 and SIL - 2 R levels, peripheral T cell subsets and erythrocyte immunity in patients with primary lung cancer before and after chemotherapy, and their clinical significance in the occurrence and development of lung cancer. Methods: Twenty - five patients with pathologically diagnosed lung cancer underwent TNM staging. Patients in NSCL C were treated with MEP and in patients with SCL C were treated with EP. Chemotherapy was used to detect the levels of IL - 2 and SIL - 2R before and after treatment. SPA bacterial wreath double labeling method to detect T cell subsets, according to Guo Fung France detected erythrocyte immune indicators. 20 healthy blood donors were used as control to explore the relationship between the dynamic changes of these indexes and the occurrence and development of lung cancer. The level of IL - 2 in patients with lung cancer before chemotherapy was significantly lower than that in controls. The expression of SIL - 2 R was significantly higher than that in controls. After chemotherapy, the level of IL - 2 increased significantly and the level of SIL - 2 R decreased significantly. Furthermore, there is a highly negative correlation between IL - 2 level and SIL - 2R content. The levels of CD3, CD4 and CD4 / CD8 in patients with lung cancer before chemotherapy were significantly lower than those in controls, while those in CD8 were significantly higher than those in controls. After chemotherapy, these indicators showed a correspondingly negative change. CD4 / CD8 was significantly different from that before chemotherapy. However, except CD8, the remaining were still lower than the control. The RBC-C3b RR and RBC-ICR of the red flag were significantly lower than and higher than the control, although the improvement after chemotherapy, but still significant differences compared with the control. Further analysis showed a high degree of positive correlation between CD4 / CD8 ratio and RBC-C3b RR. Conclusion: There are many immune disorders in patients with lung cancer. The dynamic detection before and after chemotherapy is helpful to make a reference evaluation of the occurrence, development, curative effect and prognosis of lung cancer.
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