【摘要】：目的:探討頭頸部鱗癌患者手術(shù)前后細胞免疫水平及意義。方法:該研究回顧性分析了在2015年1月至2017年1月期間收住于廣西醫(yī)科大學附屬腫瘤醫(yī)院頭頸外科手術(shù)的52例初治頭頸部鱗癌患者的臨床資料,選擇同一時期內(nèi)在廣西醫(yī)科大學附屬腫瘤醫(yī)院體檢的52例健康者作為對照組,應(yīng)用流式細胞術(shù)檢測,比較對照組及在病例組手術(shù)前3天、手術(shù)后第7天、手術(shù)后第14天以及手術(shù)后第21天組間外周血CD3+細胞、CD4+細胞、CD8+細胞、CD19+細胞和自然殺傷細胞(NK細胞)水平以及CD4+/CD8+比率的變化。結(jié)果:1.病例組患者CD4+、NK細胞水平均明顯低于健康者,而CD19+細胞水平顯著升高(P0.05);2.病例組患者術(shù)后7d的外周血淋巴細胞CD8+、CD19+顯著低于術(shù)前(P0.05),CD3+、CD4+、NK細胞水平以及CD4+/CD8+比率顯著高于術(shù)前(P0.05);3.病例組患者術(shù)后14d外周血淋巴細胞CD3+,CD4+、NK細胞水平以及CD4+/CD8+比率顯著高于術(shù)前(P0.05),CD8+、CD19+細胞水平顯著低于術(shù)前(P0.05);4.術(shù)后21d的外周血淋巴細胞CD3+,CD4+、NK細胞水平以及CD4+/CD8+比率顯著高于術(shù)前(P0.05),CD8+、CD19+細胞水平顯著低于術(shù)前(P0.05);5.術(shù)后14d的NK細胞水平較術(shù)后7d顯著性增高(P0.05),其余組無統(tǒng)計學差異(P0.05);6.術(shù)后21d的外周血淋巴細胞CD19+、NK細胞水平顯著高于術(shù)后7d(P0.05),CD8+低于術(shù)后7d(P0.05);7.病例組頭頸部鱗癌患者術(shù)后14d與21d外周血淋巴細胞CD3+、CD4+、CD8+、CD19+、NK細胞水平及CD4+/CD8+比率無統(tǒng)計學差異;8.Ⅲ~Ⅳ期患者的外周血淋巴細胞CD3+、CD4+細胞水平低于Ⅰ~Ⅱ期的患者(P0.05),CD8+細胞水平顯著升高(P0.05);9.有淋巴結(jié)轉(zhuǎn)移的患者外周血淋巴細胞CD3+、CD4+、CD4+/CD8+比率細胞水平顯著降低(P0.05),CD8+、CD19+細胞水平顯著升高(P0.05)。結(jié)論:結(jié)果表明,1、與健康者比較,頭頸部鱗癌患者術(shù)前的細胞免疫水平相對較低;2、手術(shù)切除腫瘤后,頭頸部鱗癌患者的細胞免疫水平可逐漸改善;3、晚期、有淋巴結(jié)轉(zhuǎn)移的頭頸部鱗癌患者細胞免疫水平均較低,提示頭頸部鱗癌患者的細胞免疫水平與臨床分期、有無淋巴結(jié)轉(zhuǎn)移相關(guān)。
[Abstract]:Objective: to investigate the level and significance of cellular immunity in patients with head and neck squamous cell carcinoma before and after operation. Methods: the clinical data of 52 patients with head and neck squamous cell carcinoma who were admitted to surgery of head and neck surgery in the tumor Hospital affiliated to Guangxi Medical University from January 2015 to January 2017 were retrospectively analyzed. Fifty-two healthy persons who were examined in the tumor Hospital affiliated to Guangxi Medical University during the same period were selected as the control group. Flow cytometry was used to detect and compare the control group and the case group 3 days before operation and 7 days after operation. The changes of CD3 cells, CD4 cells, CD8 cells, CD19 cells and natural killer cells (NK cells) and the ratio of CD4 / CD8 in peripheral blood were observed on the 14th day after operation and the 21st day after operation. Results: 1. The levels of CD4 and NK cells in the case group were significantly lower than those in the healthy controls, while the levels of CD19 cells were significantly higher (P0.05). The levels of CD8, CD19, CD3, CD4, NK cells and CD4 / CD8 ratio were significantly lower in the patient group 7 days after operation than those before the operation (P0.05); 3. The ratio of CD4 / CD8 was significantly higher than that before the operation (P0.05). The levels of CD3, CD4, NK cells and CD4 / CD8 ratio of peripheral blood lymphocytes in the case group were significantly higher than those before the operation (P0.05), while the levels of CD8 and CD19 cells were significantly lower than those before the operation (P0.05); 4. The levels of CD3, CD4, NK cells and the ratio of CD4 / CD8 in peripheral blood lymphocytes on the 21st day after operation were significantly higher than those before operation (P0.05), while the levels of CD8 and CD19 cells were significantly lower than those before operation (P0.05). The level of NK cells on the 14th day after operation was significantly higher than that at the 7th day after operation (P0.05), but there was no significant difference between the other groups (P0.05); 6. The levels of CD19 and NK cells in peripheral blood lymphocytes on day 21 after operation were significantly higher than those at 7 days after operation (P0.05), and the levels of CD8 were lower than those at 7 days after operation (P 0.05). There was no significant difference in the levels of CD3, CD4, CD8, CD19, NK cells and CD4 / CD8 ratio between 14 days and 21 days after operation in the patients with head and neck squamous cell carcinoma in the case group. 8. The levels of CD3 and CD4 cells in patients with stage 鈪，

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