放疗对肿瘤患者免疫功能的影响及临床意义

目的 研究放射治疗对肿瘤患者免疫功能的影响.方法 选取本院120例恶性肿瘤患者为研究对象,采取流式细胞仪检测患者放疗前后免疫功能指标CD3、CD4、CD8、CD56、CD4/CD8,比较放疗对免疫功能的影响,同时根据不同靶体积、放疗剂量及是否出现骨髓抑制进行分组,比较组间免疫功能的差异,以分析不同放疗信息患者之间免疫功能的具体差异.结果 120例患者放疗前后CD3比较无统计学意义(P＞0.05),放疗后CD4、CD56及CD4/CD8分别为(26.88±1.76)％、(10.26±0.97)％、(0.74±0.02),与放疗前(34.66±2.02)％、(19.25±2.01)％、(1.24±0.05)]比较显著降低(P＜0.05),CD8放疗后为(34.02±1.98)％,与放疗前(28.55±1.96)％]比较显著升高(P＜ 0.05);＜60Gy放射剂量患者CD56低于≥60 Gy者(P＜0.05),而CD4/CD8高于≥60 Gy者(P＜0.05),靶体积＜397cm3者CD4、CD56、CD4/CD8高于靶体积≥397 cm3者(P＜0.05),CD8低于靶体积≥397 cm3者(P＜ 0.05);120例患者中,共47例在放疗中或放疗后出现骨髓抑制,与无骨髓抑制患者比较,骨髓抑制患者CD4显著较低(P＜0.05),其他免疫指标比较差异无统计学意义(P＞0.05).结论 放疗可导致恶性肿瘤患者免疫功能降低,放疗剂量及靶体积对免疫功能均有不同程度影响,其中以靶体积影响更为显著,放疗剂量越高、靶体积范围越大,则免疫抑制越明显,而有关骨髓抑制与免疫抑制的相关性仍需要更大样本的研究.

Effect of radiotherapy on immune function of tumor patients and its clinical significance

Objective To study the effect of radiotherapy on the immune function of tumor patients.Methods 120 patients with malignant tumors were selected from our hospital as study objects.The immune function indexes (CD3,CD4,CD8,CD56,and CD4/CD8) were detected by flow cytometry before and after radiotherapy.The effect of radiotherapy on immune function were compared.Meanwhile,according to different target volume,radiotherapy dose,and whether there was myelosuppression,they were grouped.The immune function was compared between groups to analyze the specific differences of immune function between patients with different radiotherapy information.Results There was no statistical difference in CD3 between before and after radiotherapy in the 120 patients (P ＞ 0.05).CD4,CD56,and CD4/CD8 were significantly lower and CD8 was significantly higher after than before radiotherapy (26.88±1.76)％ vs.(34.66±2.02)％,(10.26±0.97)％ vs.(19.25±2.01)％,and (0.74±0.02) vs.(1.24±0.05) and (34.02±1.98)％ vs.(28.55±1.96),P ＜ 0.05].CD56 was lower and CD4/CD8 was higher in the patients with radiation dose ＜ 60 GY than in those ＞ 60 GY (P ＜ 0.05).CD4,CD56,and CD4/CD8 were higher and CD8 was lower in the patients with target volume ＜ 397 cm3 than those ＞ 397 cm3 (P ＜ 0.05).Among the 120 patients,47 got myelosuppression during radiotherapy or after radiotherapy.Compared with CD4 was significantly lower in the patients with myelosuppression than in those without (P ＜ 0.05);but there were no statistical differences in other indexes between the patients with myelosuppression and those without (P ＞ 0.05).Conclusions Radiotherapy can decrease of the immune function in patients with malignant tumors.Radiation dose and target volume,especially target volume,affect immune function in different degrees.The bigger radiation dose is and the larger target volume is,the more obvious immunosuppression is.The correlation between myelosuppression and immunosuppression still needs larger sample research.