Department of Obstetrics and Gynecology, Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China.
Gynecol Obstet Invest. 2011;71(3):177-82. doi: 10.1159/000317255. Epub 2010 Dec 14.
To explore the impact of laparoscopy and laparotomy surgery on cellular immunity in patients with malignant uterine tumors.
Thirty-eight women with uterine malignancies were enrolled in a prospective nonrandomized cohort study. Either laparoscopy or laparotomy was performed according to the patients' choice. The frequency of CD3+, CD4+, CD8+ T cells and natural killer cells derived from peripheral venous blood was evaluated by flow cytometry.
(1) Postoperatively, there was a decrease in the number of lymphocyte counts, especially after laparotomy, on the first postoperative day (p < 0.01). (2) Compared with preoperative levels, the frequencies of CD3+ and CD4+ cells and the CD4+/CD8+ ratio were declined both in the laparoscopy and laparotomy groups on postoperative day 1 (p < 0.01). (3) The frequencies of CD3+ and CD4+ cells and the ratio of CD4+ to CD8+ cells were less depressed in the laparoscopy group on the first postoperative day (p < 0.05). (4) The frequency of natural killer cells increased, both in the laparoscopy and laparotomy groups on the first postoperative day (p < 0.01), but there were no significant differences between the two groups (p > 0.05).
Cellular immunity was temporally depressed in patients with uterine malignancy after surgical treatment, but laparoscopic surgery depressed the immunity less than laparotomy.
探讨腹腔镜与开腹手术对恶性子宫肿瘤患者细胞免疫的影响。
前瞻性非随机队列研究纳入 38 例子宫恶性肿瘤患者。根据患者选择行腹腔镜或开腹手术。采用流式细胞术检测外周静脉血中 CD3+、CD4+、CD8+T 细胞和自然杀伤细胞的频率。
（1）术后，尤其是开腹手术后第 1 天，淋巴细胞计数减少（p<0.01）。（2）与术前相比，腹腔镜组和开腹组术后第 1 天 CD3+和 CD4+细胞的频率以及 CD4+/CD8+比值均降低（p<0.01）。（3）腹腔镜组术后第 1 天 CD3+和 CD4+细胞的频率以及 CD4+/CD8+比值的下降幅度较小（p<0.05）。（4）术后第 1 天，腹腔镜组和开腹组自然杀伤细胞的频率均升高（p<0.01），但两组间无显著差异（p>0.05）。
子宫恶性肿瘤患者手术后细胞免疫暂时受到抑制，但腹腔镜手术的免疫抑制作用小于开腹手术。
