CAJ | 학술논문

目的通过测定37例妇科恶性肿瘤患者治疗前外周血中可溶性白介素-2受体（sIL-2R）、白介素-6（IL-6）、γ干扰素（IFN-γ）、淋巴细胞亚群、自然杀伤细胞及淋巴细胞转化试验（LTT）了解其免疫功能状态和临床意义。方法应用ELISA法、间接免疫荧光法及LTT测定了患者外周血sIL-2R、IL-6、IFN-γ浓度变化及淋巴细胞在植物凝血素(PHA)作用后的转化率。结果（1）37例患者治疗前sIL-2R均明显升高（P＜0.05），以卵巢癌最为突出，显著高于对照组及其它肿瘤（P＜0.01）；（2）IL-6浓度变化主要见于卵巢癌患者（P＜0.01），且与患者的病期相关（r＝0.8637，P＜0.05）；（3）CD4＋细胞显著减少，CD４／CD８比值明显下降。CD16＋、CD56＋和HLA-DR＋细胞均显著高于对照组（P＜0.01），以卵巢癌最为显著（P＜0.001）；（4）肿瘤患者外周血淋巴细胞对PHA刺激的反应明显低于正常水平（P＜0.01）。结论妇科恶性肿瘤患者细胞免疫功能减低，并随病情的恶化而下降。测定sIL-2R、IL-6、T细胞亚群及LTT有助于及时了解病情，决定治疗方案，同时也是判断预后的重要手段。
목적통과측정37례부과악성종류환자치료전외주혈중가용성백개소-2수체（sIL-2R）、백개소-6（IL-6）、γ간우소（IFN-γ）、림파세포아군、자연살상세포급림파세포전화시험（LTT）료해기면역공능상태화림상의의。방법응용ELISA법、간접면역형광법급LTT측정료환자외주혈sIL-2R、IL-6、IFN-γ농도변화급림파세포재식물응혈소(PHA)작용후적전화솔。결과（1）37례환자치료전sIL-2R균명현승고（P＜0.05），이란소암최위돌출，현저고우대조조급기타종류（P＜0.01）；（2）IL-6농도변화주요견우란소암환자（P＜0.01），차여환자적병기상관（r＝0.8637，P＜0.05）；（3）CD4＋세포현저감소，CD４／CD８비치명현하강。CD16＋、CD56＋화HLA-DR＋세포균현저고우대조조（P＜0.01），이란소암최위현저（P＜0.001）；（4）종류환자외주혈림파세포대PHA자격적반응명현저우정상수평（P＜0.01）。결론부과악성종류환자세포면역공능감저，병수병정적악화이하강。측정sIL-2R、IL-6、T세포아군급LTT유조우급시료해병정，결정치료방안，동시야시판단예후적중요수단。
Objective　To understand the immunologic state of pretreatment patients with gynecological malignant tumor by measurement of the levels of soluble interleukin-2 receptor （sIL-2R），interleukin-6（IL-6），γ-interferon（IFN-γ），T lymphocyte subtypes，nature killer cells（NKs），and lymphocyte transforming rate（LTR）．Methods　The enzyme-linked immuno-adsorbent assays （ELISA），indirect immunofluorescence assays and lymphocyte transform test after stimulated by phytohemagglutinin（PHA） were employed to determine the levels of sIL-2R，IL-6，ILN-γ，T cell subtypes，NKs and LTR in peripheral blood．Results　（1）The levels of sIL-2R were high in all pretreatment patients （P＜0.05）．In comparison with controls and other gynecological tumor，the levels of sIL-2R in ovarian cancer were much higher．（2）High levels of IL-6 were mainly seen in the ovarian cancer and were related to their clinical outcome（r＝0.8637，P＜0.05）．（3）CD４＋ cell and CD４／CD８ rate were significantly decreased．High expression of CD16，CD56，and HLA-DR were always seen in those patients （P＜0.01）．（4）The reaction of peripheral blood lymphocytes to PHA was low，especially in those with ovarian cancer （P＜0.01）．Conclusion　The immunologic state was impaired in those patients with gynecological malignant tumor and was parallel to the clinical state．The results of our study showed that measurement of sIL-2R，IL-6，T cell subtypes and LTR were important for us to understand the patient’s clinical state，determine the proper treatment protocol and may represent an important prognostic factor of the likely outcome in cancer patients．