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自体输血与异体输血对食管癌手术患者围手术期白细胞介素及肿瘤坏死因子-α的影响

Influence of autologous and homologous blood transfusion on interleukins and tumor necrosis factor-α in peri-operative patients with esophageal cancer.

作者信息

Xing Yue-Li, Wang Yan-Chun

机构信息

Department of Blood Transfusion, Binzhou Medical University Hospital, Binzhou, China E-mail :

出版信息

Asian Pac J Cancer Prev. 2014;15(18):7831-4. doi: 10.7314/apjcp.2014.15.18.7831.

Abstract

OBJECTIVE

To explore the influence of different ways of blood transfusion on the expression levels of interleukins (IL) and tumor necrosis factor-α (TNF-α) inperi-operative patients with esophageal cancer.

MATERIALS AND METHODS

A total of 80 patients with esophageal cancer who underwent radical operations were selected as study patients and randomly divided into an observation group (treated with autologous blood transfusion) and control group (with homologous blood transfusion). Changes of intra-operative indexes and peri-operative blood indexes, from hemoglobin (Hb) and hematocrit value (Hct), to levels of inflammatory factors like interleukins-6 (IL-6), IL-8, IL-10 and tumor necrosis factor-α (TNF-α) were compared.

RESULTS

Operations for patients in both groups were successfully conducted, and no significant differences in mean surgical duration and intra-operative hemorrhage volume, fluid infusion volume and blood transfusion volume were detected (p>0.05). Compared with values before surgery, Hb and Hct levels decreased significantly while white blood cell count (WBC) increased 1, 5 and 7 d after operation (p<0.05, p<0.01). In addition, WBC was apparently higher in observation group than in control group 5 and 7 d after operation (p<0.01). Compared with before surgery, in the observation group, levels of IL-6, IL-8 and IL-10 had no significant differences after operation (P>0.05), but TNF-α level increased y (p<0.01), whereas in control group, IL-6 level had no significant difference (p>0.05), IL-8 level decreased obviously (p<0.05), IL-10 level increased markedly first and then decreased gradually as time passed but its level remained elevated (p<0.01), and TNF-α level increased first and then decreased, and there was no significant difference 7 d after operation (p>0.05).

CONCLUSIONS

Decreased IL-8 and increased IL-10 levels are two important reasons forimmunosuppression after homologous blood transfusion, whereas autologous blood transfusion can alleviate this while increasing the TNF-α level, which also has potential to improve anti-tumor immunity in the human body.

摘要

目的

探讨不同输血方式对食管癌围手术期患者白细胞介素(IL)及肿瘤坏死因子-α(TNF-α)表达水平的影响。

材料与方法

选取80例行根治性手术的食管癌患者作为研究对象,随机分为观察组(采用自体输血治疗)和对照组(采用异体输血治疗)。比较两组患者术中指标及围手术期血液指标的变化,包括血红蛋白(Hb)、血细胞比容值(Hct)以及白细胞介素-6(IL-6)、IL-8、IL-10等炎症因子水平和肿瘤坏死因子-α(TNF-α)水平。

结果

两组患者手术均顺利完成,平均手术时长、术中出血量、液体输注量及输血量比较,差异均无统计学意义(p>0.05)。与术前相比,术后1、5、7天Hb和Hct水平显著降低,白细胞计数(WBC)升高(p<0.05,p<0.01)。此外,术后5、7天观察组WBC明显高于对照组(p<0.01)。与术前相比,观察组术后IL-6、IL-8和IL-10水平差异无统计学意义(P>0.05),但TNF-α水平升高(p<0.01);而对照组中,IL-6水平差异无统计学意义(p>0.05),IL-8水平明显降低(p<0.05),IL-10水平先显著升高,随后随时间逐渐下降,但仍高于术前水平(p<0.01),TNF-α水平先升高后降低,术后7天差异无统计学意义(p>0.05)。

结论

IL-8水平降低和IL-10水平升高是异体输血后免疫抑制的两个重要原因,而自体输血可缓解这一情况,同时提高TNF-α水平,这也有可能增强机体的抗肿瘤免疫力。

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