Research On The Effect Of White Cell-depleted Transfusion During The Perioperative Period On Immune Function In Patients With Esophageal Carcinoma

Objective: Our research is to prospectively evaluate the effect of white cell-de pleted transfusion on immune function in patients with esophageal carcinoma and aim to offer the theoretical and clinical foundation for utilization of white ce ll-depleted by measuring the positive percent of T-lymphocyte subsets and NK cel l and observing the level of TNF-αand IL-2 in peripheral blood. Methods: Sample s derivation: forty-five patients with esophageal carcinoma were selected from t he patients stayed in the department of cardiothoracic surgery of the fourth aff iliated hospital of the Hebei medical university form May.2001 to Nov.2002. Ther e were 24 males and 21 females. The range of age is 45-65 years old, and the ave rage is 53.1. Selected criterion: all patients were diagnosed with squamous cell carcinoma by the way of barium meal esophagogram and esophagoscopy, 25 in the m iddle of chest esophagus and 20 in the lower. According to TNM stage system prop osed by UICC in 1989, all patients were inⅡ-Ⅲstage. There were no distance met astasis through clinical examination or immune diseasefound among patients, and also they did not received radiotion-therapy, chemoth erapy and other drugs which affect immune function. All underwent esophagectomy and esophagogastrostomy through the bed of the sixth back-rib. Anesthesia was ma intained with isofluane. Samples grouping: all patients were divided into three groups, test group (white cell-depleted transfusion, C ), control groupⅠ(no tra nsfusion, A ) and control groupⅡ(no-depleted white cell transfusion, B ). Norma l group was the healthy man who voluntarily donated blood. The way of observing the level of TNF-αand IL-2 : Take blood samples of patients from peripheral vei n one day before operation and on first, third, seventh, twelfth day after opera tion; Extract serum, then measure the level of TNF-αand IL-2 by Radioimmunoassa y(RIA) according to specification for reagent-box. The way of measuring the posi tive percent of T-lymphocyte subsets and NK cell: Take blood samples of patients from peripheral vein one day before operation and on first, third, seventh, twe lfth day after operation; Put into anticoagulant tubes, then measure the positiv e percent of T-lymphocyte subsets and NK cell by flow cytometry(FCM). Statistica l analysis: all data are showed in the way of mean±standard-deviation(x±s). Th e analysis way is one-way and two-way ANOVA though SPSS10.0 soft and P<0.05 is s ignificant. Results: (1) the results of value of CD3,CD4+/ CD8+and NK cell and the level of IL-2 peripheral vain shows: the numerical valueof patients with esophageal carcinoma before surgery is lower than those of norm al man (p<0.05); On the first day and the third day after surgery the values of CD3,CD4+/ CD8+, NK cell and IL-2 is lower than preoperative values(p<0.05); Th e value of test group and control group 1 recover faster. Seven day after surger y the values go up to the level of preoperative values. But control group 2 reco vers slowly, furthermore, the values 12 days after surgery do not completely go up to the preoperative level, and in the corresponding period of postoperation t he values are partly lower, compared with test group and control group 1 (p<0.05 ).There is no significant difference among values of test group and control grou p 1 (p>0.05). (2) The results of the level of TNF-αshow: the preoperative value s of patients with esophageal carcinoma is higher than that of normal man(p<0.05 ); On the first and third day after surgery the level of TNF-αrises compared wi th preoperative values (p<0.05). On the third days after surgery the value get t o top and on the seventh day after surgery the value go down, but is still highe r than preoperative values (p<0.05); The rising extent of the value of control g roup 2 is partly lower than that of others in the corresponding period of postop eration (p<0.05). The rising extent of the value of test group and control group 1 is about equal (p>0.05). Conclusions: (1) White cell-depleted...