乳腺癌应用电化学合并三苯氧胺治疗（附37例报告）

目的 对乳腺恶性肿瘤不论是原发或复发转移失去手术机会，年老体弱不易手术或不愿接受手术的患者均可采用电化学治疗（ECT）。方法 应用北京原子能科学院研制的WL－A型电化学治疗仪，在肿瘤部位插入阴，阳电极针分别连接到治疗仪通电治疗；11例原发乳腺癌自电化学治疗开口服服三苯氧胺（TAM）三年。结果 本组ECT治疗乳腺恶性肿瘤37例，按国际ECT协会评定疗效的标准；CR26例，PR6例，总有效率为86．3％（CR＋PR32／37）。结论 乳腺癌应用电化学合并三苯氧胺治疗创伤小，操作简单，疗效满意。     

维甲酸对大肠癌患者T淋巴细胞亚群及集落形成的影响

背景与目的：维甲酸是维生素A的衍生物,可完全或部分阻断实验性大肠癌的癌变过程,降低大肠癌的发生率。但对大肠癌患者T淋巴细胞亚群及集落形成的影响,尚未见报道。本文的目的是探索维甲酸对大肠癌患者免疫功能的影响。方法：对40例大肠癌患者进行前瞻性研究,所有患者均行大肠癌根治术。将病例随机分为维甲酸治疗组和对照组（每组20例）,分别在术前及术后检测两组患者外周血中T淋巴细胞亚群、T淋巴细胞集落形成和血清免疫球蛋白水平。结果：（1）两组术中OKT3无显著性变化,而OKT4、T4／T8的增加及OKT8的下降有统计学意义（P＜0．05）。两组对比,维甲酸治疗组OKT3、OKT4及T4／T8显著高于对照组,OKT8差异则无统计学意义（P＞0．05）。（2）维甲酸治疗组患者T淋巴细胞集落数显著低于正常人T淋巴细胞集落数,但却显著高于对照组大肠癌患者T淋巴细胞集落数（P＜0．05）。结论：大肠癌根治术后应用维甲酸,可提高患者的细胞免疫及体液免疫功能,促进免疫抑制状态的恢复。     

放射治疗对鼻咽癌患者细胞免疫功能的影响

应用抗人淋巴细胞单克隆抗体检测32例鼻咽癌患者放疗前、后外周血T淋巴细胞亚群，并与12例非癌人群（对照组）进行对比。结果：鼻咽癌患者OKT3、OKT4及OKT4/OKT8值与对照组相比明显降低，OKT8值显著上升（P＜0．05）；放疗后OKT3、OKT4及OKT4/OKT8值进一步下降，OKT8进一步升高（P＜0．01）。提示鼻咽癌患者细胞免疫功能低下，放射治疗可进一步抑制鼻咽癌患者的细胞免疫功能。     

乌苯美司对肺鳞癌化疗患者免疫功能的影响

目的 评价乌苯美司对肺鳞化疗患者免疫功能的影响。方法 将56例未手术肺鳞癌患者按3：2的比例随机分入试验组（34例）及对照组（22例）,患者均接受CAP方案化疗,每21天为1周期,共3个周期;试验组加服乌苯美司30mg,每日1次,共6个月。分析化疗疗效,观察治疗前、治疗后3、6个月淋巴细胞绝对计数（LC）、OKT4／T8、NK细胞活性、血清IL－2、SIL－2R水平的变化情况。结果 在可评价的52例（试验组32例,对照组20例）患者中,两组间近期化疗疗效无统计学差异（P＞0．05）。治疗后3、6个月,试验组OKT4／T8比值、NK细胞活性及IL－2水平均较治疗前明显提高（P＜0．05）,但前二项指标与对照组比较无统计学差异（P＞0．05）,而后一项则有明显统计学差异（P＜0．05）;治疗后3、6个月,试验组患者血清SIL－2R水平均较治疗前降低（P＜0．05）,但组间差异比较无统计学意义,而对照组除治疗后6月SIL－2R水平较治疗前明显降低外（P＜0．05）,其余各项指标与治疗前比较均无显著性差异。结论 乌苯美司对肺鳞癌化疗患者OKT4／T8比值、NK细胞活性、血清IL－2和SIL－2R有一定程度的改善作用,但其临床应用价值仍需进一步观察确定。     

艾迪注射液防治大肠癌术后早期免疫功能下降的临床疗效

目的 :探讨大肠癌患者手术前后免疫功能的变化 ,以及艾迪注射液防治术后早期免疫功能下降的作用。方法 :大肠癌对照组 30例 ,治疗组 2 0例。每例患者术前及术后 1、2、3周分别采用APAA法测定NK细胞活性和T淋巴细胞亚群。其中治疗组于术前 5d和术后 5d连续使用艾迪 5 0mL +5 %GS4 5 0mL静脉滴入。结果 :大肠癌患者NK细胞活性及OKT3+、OKT4 +明显低于正常组 ,而OKT8+则明显增加 ,P <0 0 5 ,术后免疫功能进一步下降 ,2周后逐渐恢复 ;治疗组术后免疫功能无明显改变。结论 :艾迪注射液对防治大肠癌患者术后早期免疫功能下降 ,具有重要意义     

乳腺癌应用电化学合并三苯氧胺治疗(附37例报告)

目的　对乳腺恶性肿瘤不论是原发或复发转移失去手术机会、年老体弱不易手术或不愿接受手术的患者均可采用电化学治疗 (ECT)。方法　应用北京原子能科学院研制的WL -A型电化学治疗仪 ,在肿瘤部位插入阴、阳电极针分别连接到治疗仪通电治疗 ;11例原发乳腺癌自电化学治疗开始口服三苯氧胺 (TAM)三年。结果　本组ECT治疗乳腺恶性肿瘤 37例 ,按国际ECT协会评定疗效的标准 ;CR 2 6例、PR 6例 ,总有效率为 86 5 % (CR +PR 32 /37)。结论　乳腺癌应用电化学合并三苯氧胺治疗创伤小、操作简单、疗效满意     

电化学治疗中晚期宫颈癌远期疗效评价

 通过对114例接受电化学加放疗和68例单纯放疗的中晚期宫颈癌患者远期疗效的对比观察，结果：（1）电化学组患者3、5年生存率明显高于单纯放疗组，但1年生存率两组无明显差异。（2）临床期别早，肿瘤直径小及菜花型患者电化学治疗后远期疗效好，但疗效与肿瘤的病理类型和分化级别无相关。（3）治疗剂量以150库仑／1cm肿瘤直径计算，2次或以上的治疗其远期疗效较好。（4）电化学治疗组的复发率低于单纯放疗组，且复发部位有所不同。因此，采用电化学配合放疗治疗中晚期宫颈癌是一种值得应用的新方法。     

电化学治疗动物肿瘤的实验研究

应用电化学治疗(ECT)艾氏腹水癌、肉瘤S37和Lewis肺癌,结果显示,ECT对三种移植性肿瘤均有明显局部治疗作用,但对Lewis肺癌肺转移无明显影响。提示ECT是一种简单、安全、治疗时间短和比较有效的治疗肿瘤的方法。     

恶性骨肿瘤术后免疫联合治疗对免疫状态的影响及其无瘤生存影响意义

 目的　探讨手术后的恶性骨肿瘤患者经自体瘤苗及TF联合免疫治疗对T4 T8值影响作用 ,研究T4 T8值变化和免疫综合治疗对无瘤生存率的影响。方法　抗人T细胞OKT系统OKT4 、OKT8检测T4 T8值 ,自体瘤苗的转移因子分别皮内注射和皮下注射 ,复查随访无瘤生存率。结果　治疗使无瘤生存率提高 ,使T4 T8值升高 ,而T4 T8值与无瘤生存相关不大。结论　联合免疫治疗提高无瘤生存率 ,可提高整体免疫水平 ,而整体免疫水平无显著变化者也有显著无瘤生存率。提示手术后免疫联合治疗恶性肿瘤的作用主要是特异性抗瘤免疫的激活及敏感性升高 ,这种效应即使在较低的宏观整体免疫水平下也可起作用。     

肾移植的新免疫抑制疗法

我们收集当前几种有较好远期疗效药物的实验和最初临床经验,这些药物能很好地预防排斥反应,可能不久会作为免疫抑制剂而应用于临床。生物免疫抑制剂——单克隆抗体 OKT3,一种抗T细胞受体-/CD3-分子复合物的抗体,是临床上首先使用的有强效抗排斥作用的单克隆抗体中的典型代表。 OKT3可以修饰CD3分子和T细胞受体(一个功能单位)并使之进入细胞内,因而抑制抗原识别功能。给予首剂OKT3数分钟内CD3阳性细胞全部从血液中消失,而在治疗结束后的头3周才缓慢出现。所有其它T细胞标志,如CD2、CD4、CD8最初也消失,但在随后的治疗中又出现。     

Effects of PSK on interleukin-2 production by peripheral lymphocytes of patients with advanced ovarian carcinoma during chemotherapy

The effects of PSK on OKT 4/OKT 8 cell ratio, interleukin-2 (IL-2) production and expression of IL-2 receptor were examined in peripheral blood lymphocytes (PBL) from patients with advanced ovarian cancer during the course of chemotherapy. Preoperative levels of OKT 4/OKT 8 cell ratio and IL-2 production in PBL from patients with advanced ovarian cancer were significantly lower than those in cases of benign ovarian tumor. However, the expression of IL-2 receptor did not show any significant difference between ovarian cancer and benign ovarian tumor patients. When a combination chemotherapy of cisplatin, adriamycin and cyclophosphamide was given, the OKT 4/OKT 8 cell ratio was significantly increased with a significant decrease of the absolute number of the OKT 8 cell subset, while the expression of IL-2 receptor and the absolute number of the OKT 4 cell subset remained unchanged. In contrast, the IL-2 production was markedly depressed after the first course of chemotherapy. When PSK was combined with combination chemotherapy, the degree of inhibition of IL-2 production was reduced (though the effect was not statistically significant). If treatment with PSK was initiated after completion of combination chemotherapy, in addition to a significant elevation of OKT 4/OKT 8 cell ratio the depressed IL-2 production was restored to benign control levels. On the other hand, the expression of IL-2 receptor remained unchanged even if PSK was given after completion of chemotherapy.     

Effects of PSK on Interleukin-2 Production by Peripheral Lymphocytes of Patients with Advanced Ovarian Carcinoma during Chemotherapy

The effects of PSK on OKT 4/OKT 8 cell ratio, interleukin-2 (IL-2) production and expression of IL-2 receptor were examined in peripheral blood lymphocytes (PBL) from patients with advanced ovarian cancer during the course of chemotherapy. Preoperative levels of OKT 4/OKT 8 cell ratio and IL-2 production in PBL from patients with advanced ovarian cancer were significantly lower than those in cases of benign ovarian tumor. However, the expression of IL-2 receptor did not show any significant difference between ovarian cancer and benign ovarian tumor patients. When a combination chemotherapy of cisplatin, adriamycin and cyclophosphamide was given, the OKT 4/OKT 8 cell ratio was significantly increased with a significant decrease of the absolute number of the OKT 8 cell subset, while the expression of IL-2 receptor and the absolute number of the OKT 4 cell subset remained unchanged. In contrast, the IL-2 production was markedly depressed after the first course of chemotherapy. When PSK was combined with combination chemotherapy, the degree of inhibition of IL-2 production was reduced (though the effect was not statistically significant). If treatment with PSK was initiated after completion of combination chemotherapy, in addition to a significant elevation of OKT 4/OKT 8 cell ratio the depressed IL-2 production was restored to benign control levels. On the other hand, the expression of IL-2 receptor remained unchanged even if PSK was given after completion of chemotherapy.     

Peripheral blood and tumor-infiltrating mononuclear cell analysis in esophagus and head and neck cancer

We show a significantly decreased number of OKT3+ lymphocytes in the peripheral blood (PB) of cancer patients mainly due to a reduced number of OKT4 cells. OKT8 cells were also somewhat reduced. The numbers of DR+ and interleukin-2 receptor-bearing T-cells were significantly increased in patients. The tumor-infiltrating cells included OKT4+ AND OKT8+ lymphocytes. There was a significant correlation between the proportion of activated T-cells in PB and in tumor, as shown by DR and interleukin-2 receptor expression.     

ECT2 mRNA及蛋白在胃癌患者外周血中的表达及意义

目的:探讨ECT2 mRNA及蛋白在胃癌患者外周血中的表达水平及其意义。方法:应用逆转录聚合酶链式反应（RT-PCR）及酶联免疫吸附实验（ELISA）测定50例胃癌患者及30例健康志愿者外周血ECT2 mRNA及蛋白的表达水平。结果:胃癌患者外周血中ECT2 mRNA阳性表达率为54%,健康志愿者外周血中ECT2 mRNA均阴性表达(P<0.05)。ECT2蛋白在胃癌患者外周血中的浓度（1 306.389±215.824)ng/L显著高于健康志愿者外周血中的浓度（502.718±69.440)ng/L(P<0.05),并且与TNM分期、淋巴结转移和浸润深度相关(P<0.05)。结论:外周血中ECT2 mRNA及蛋白的表达与胃癌关系密切,可作为反映胃癌发生、发展过程的有效分子指标。     

Suppression of cellular immunity in patients with carcinoma in situ and microinvasive cancer of the cervix uteri]

Monoclonal antibodies (Ortho type) were used for immunocytochemical evaluation of cell-mediated immunity in peripheral blood from 29 patients with in situ (TisNoMo) and microinvasive (T1aNoMo) cervical carcinoma. The total number of T cells (OKT3+) was decreased in both patient groups compared to healthy volunteers. Marked difference between OKT4+ (helper/inducer) and OKT8+ (suppressor/cytotoxic) cells was observed OKT8+ level rose with advancement of disease, resulting in inverted OKT4+/OKT8+ ratio in T1aNoMo cancer patients. Antitumor immune resistance proved inhibited in both study groups manifesting itself in suppression of cell-mediated immunity.     

肺癌与结核性胸水中淋巴细胞表型及活化为EAL的研究

用单克隆抗体（ＯＫＴ３，ＯＫＴ４，ＯＫＴ８，ＯＫＴ１１）检测肺癌胸水１７例和结核性胸膜炎１７例胸水中的淋巴细胞表型。结果：结核组淋巴细胞绝对数高于癌性胸水。结构组Ｔ３＋，Ｔ４＋，Ｔ１１＋的百分数和绝对数均高于癌性胸水，有显著差异，结核组Ｔ８＋绝对数高于肺癌组，百分数低于肺癌组。肺癌及结核性胸水中的淋巴细胞均可被ＩＬ－２激活为ＥＡＬ，可杀伤肺癌细胞系及新鲜肿瘤细胞。两者相比，结核组杀伤活性高于肺癌组，差异有显著性。ＥＡＬ的活性可反映胸水局部免疫状态。     

食管癌术前电化学治疗的临床病理研究

目的 :研究术前电化学治疗对食管癌的作用。方法 :5 0例经胃镜及病理诊断为食管鳞癌病人术前行电化学治疗 ,治疗电压 :5 6v ,电量 :2 5 0 35 0c ;全部病人予电化学治疗后 1 3天接受外科手术治疗 ;术后标本作肉眼观察及组织病理、电镜观察。结果 :经病理及临床观察研究发现 ,肿瘤表面与电极接触区阳极黑痂凝固性坏死 ,阴极区水肿性坏死 ,疗效以缩窄型最佳 ,其余类型均伴有正常食管壁损伤 ,电量达 30 0c时损伤达外膜层。结论 :1、电化学治疗为食管癌综合治疗提供了新手段 ,其操作简便、安全有效 ,尤其是不能手术或不能耐受手术的高龄、高危中晚期病人 ,宜积极行电化学治疗。 2、由病理及临床观察发现 ,现用电极对肿瘤未侵及食管全周者极易损伤正常食管壁 ,急需改进、完善电极。     

Changes in peripheral lymphocyte subsets during radiotherapy for lung cancer patients

In order to better understand the immunologic effects of irradiation, blood levels of lymphocyte subsets were sequentially monitored in 37 patients before and during irradiation treatment for lung cancer. During irradiation, the peripheral blood levels of each T cell subgroup, OKT3-reactive (OKT3+), OKT4+, OKT8+ and OKT11+ lymphocytes showed similar radiosensitivity. No selective depletion of either OKT4+ or OKT8+ lymphocytes was seen. The levels of OKT6+ and OKT9+ lymphocytes were different depending on the case. At the end of irradiation, the percent of lymphocytes bearing the OKT10 antigen increased significantly. As to OKM1+ and OKIa1+ lymphocytes, the levels were almost consistent but showed a rather big standard deviation.     

Effects of antiestrogen and progestin on immune functions in breast cancer patients

Several immunologic variables were evaluated in 14 patients with untreated primary breast cancer and 20 postmastectomized patients undergoing tamoxifen (TAM) or high-dose medroxyprogesterone acetate (MPA) treatment. Immunologic evaluation in the peripheral blood included lymphocyte count, definition of T-lymphocyte subsets by monoclonal antibodies (OKT3, OKT11, OKT4, and OKT8), and lymphocyte blastogenic response to phytohemagglutinin (PHA) and Concanavalin A (Con A). Moreover, the in vitro effect of TAM and MPA on the blastogenic response of peripheral lymphocytes from normal female subjects was tested. Primary breast cancer patients did not differ from controls in any of the variables tested. Similarly, the immunologic variables of the group treated with TAM were normal, with the exception of a slight reduction of the OKT4+/OKT8+ ratio. In MPA-treated patients, a reduction of the percentage of OKT4+ cells and a decrease of the OKT4+/OKT8+ ratio were observed. Moreover, response to PHA was reduced sharply. However, the addition of interleukin-2 (IL-2) to the culture medium restored PHA response. Likewise, the in vitro addition of MPA to peripheral blood lymphocytes from normal female subjects resulted in a sharp dose-dependent depression of PHA response while TAM was ineffective completely. The inhibitory effect of MPA was not evident when IL-2 was added simultaneously to the culture medium. These results show that the administration of high-dose MPA may alter immunocompetence as defined by T-lymphocyte subsets and response to mitogens. The latter effect may be related to a diminished production of IL-2. In contrast, TAM does not appear to have a significant immunodepressant action either in vitro or in vivo.