RESUMEN
Objective:To detect the proportion of lymphocyte subsets in peripheral blood of the ad-vanced breast cancer patients before and after chemotherapy with docetaxel and thiotepa,as well as the association between the proportion of peripheral blood lymphocyte subsets with the response rate and prog-nosis.Methods:The proportions of lymphocyte subsets (CD3 +T cell,CD3 +/CD4 +T cell,CD3 +/CD8 +T cell,CD3 -/CD16 +56 +NK cell,CD3 +/CD16 +56 +T cell,CD19 +B cell,CD4 +/CD25 +T cell,CD8 +/CD28 -T cell,CD8 +/CD28 +T cell)in the peripheral blood of 86 patients were analyzed with flowcytometry before and after chemotherapy.The result was analyzed in combination with clinico-pathological data.Results:The proportion of regulatory T cells (Treg)after chemotherapy in the disease control patients decreased significantly compared with that of the progressive patients (P=0.034).The difference of the proportions of Treg before and after chemotherapy affected significantly the overall survi-val (OS).The OS of the patients with decreased proportion of Treg was significantly longer than that of the patients with increased proportion of Treg,which was 23.5 and 9.4 months respectively (P<0.05). Conclusion:The patients with decreased proportion of Treg after chemotherapy had higher response rate and better survival benefit.
RESUMEN
Objective The aim of this study was to investigate the effects of different anesthetic drugs and techniques on serum SIL-2R, IL-6 and TNF-? in cancer patients undergoing elective thoracic surgery, trying to find a reasonable anesthesia for patients with compromised immune function. Methods Eighteen ASA Ⅰ-Ⅱ cancer patients(male 12, female 6) undergoing elective thoracic surgery were studied. The age ranged from 46-47 years. 6 patients suffered from lung cancer and 12 from cancer of esophagus or cardia. The patients received no radio-or chemotherapy before surgery. They were premedicated with intramuscular pethidine 50mg and atropine 0.5mg. Esophogus and cardia cancer patients were randomly divided into two groups: group Ⅱ and Ⅱ . Group Ⅲconsisted of only lung cancer patients. Group I received general anesthesia combined with continuous epidural block and postoperative epidural analgesia. An epidural catheter was inserted at T7-8 or T8.9 before general anesthesia. Anesthesia was induced with 2% thiopental sodium 5mg kg-1 and vecuronimn 0.06-0 .08mg kg-1 and maintained with 1%-2% isoflurane inhalation with epidural 2% lidocaine 6-7m1o h-1 . After operation epidural analgesia was produced with 0.125% bupivacaine 5-6ml h-1 for 72 h. In group Ⅱ the induction of general anesthesia was the same as in group Ⅰ , but anesthesia was maintained with ketamine infusion 1-2mg kg-1h-1 and epidural 2% lidocaine 6-7ml h-1. Postoperative analgesia was produced with epidural 0.1% bupivacaine + 0.0003% fentanyl 5-6m1o h-1 for 72 h. In group Ⅲ the induction and maintenance of anesthesia were the same as in group Ⅱ but postoperative analgesia was produced with epidural 0.1 % ketamine 4-5ml h-1. Blood samples were taken from peripheral vein before anesthesia, before and 2 h after skin incision and on the 1st, 3rd and 5th day after operation for determination of serum SIL-2R, IL-6 and TNF-? by ELISA(Genozyme Co) Results The serum SIL-2R, IL-6 and TNF-? levels were comparable before anesthesia and operation among the three groups. Serum SIL-2R decreased significantly at 2 h after skin incision(P