| Objective: Although surgical treatment remains the first choice for patients with esophageal carcinoma, radiotherapy and chemotherapy are necessary for the disease. In recent years, many chemotheralpeutic agents have been reported to induce apoptosis, which has become an important parameter in the study of anti-cancer medication. It has been known that immune function decreases in patients with carcinoma, and the surgical operation, radiotherapy and chemotherapy further suppress immune function. Spread of cancer is more likely to occur in the patients with suppressed immune. Thus, it is necessary to use anti-cancer medication to control cancer spread in these patients. However, most chemotheralpeutic agents can not be used perioperatively because of their toxicity. Nanjing University of Traditional Chinese Medicine reported that Trametes robiniophila (a epipthyte named Huaier that growing on locust tree) could induce apoptosis of carcinoma cell and enhance host' s immune function. Our study was undertaken to detect the apoptosis of esophageal carcinoma cells induced by Huaierabstract and its impact on immune system of the patients with esophagectomy to further explore the anti-carcinoma mechanism of Huaier abstract. In addition, the changes of host' s immune function after esophagectomy for cancer were also observed.Methods: Forty patients were selected in the Fourth Hospital Hebei Medical University between August 2000 and January 2002. All patients were diagnosed with squamous cell carcinoma in lower or middle third of the esophagus. Before surgery, no distance metastasis was found by clinical examination. All patients underwent esophagectomy and anaesthesia was maintained with isoflurame. All patients were in II-III stage according to pTNM staging system proposed by UICC. There was no hematometachysis in operation. These patients were divided into test group (10 males and 10 females) and control group (10 males and 10 females) randomly. In test group, Huaier abstract was administered (20g, Tid) for 15-20 days before surgery and for 15 days after surgery. The control group took no drugs. At the beginning of experiment, T lymphocyte Ag-NORs , T lymphocyte CD4 , CDS', CD47CD8iand white blood cells were detected for each patient. These parameters were also measured at fourteenth and fortieth postoperative days. Fresh tumor specimens were obtained in operating room. One piece of specimen (about 1.0 gram) was placed in 70% alcohol and preserved in refrigerator for FCM. Another specimen wasfixed in 4% glutaraldehyde for observing morphologic change of apoptosis with electron microscope (EM). The apoptosis of tumor cells was expressed as percentage of apoptotic cells (PAC) and the percentage of the square of Ag-NORs in nucleus was used to describe the extent of Ag-NORs.Results: 1. The PAC was 7.1+2.9% in test group and was 5.2+2.6% in control group. The PAC of test group was higher than that of control group (P<0.05). 2. Electron microscope revealed that there were more apoptotic cells in test group than in control group. 3. Before surgery, Ag-NORs was not significantly different between test group (5.12 + 0.72%) and control group (5.09+0.91%). Preoperative values of CD4+,CD8+ and CD4VCD8+ were 41.1 + 10.3%, 40.4 + 9.1%, 1.03+0.25 respectively in test group and 39.3 + 9.9%, 41.3+10.5%, 1.00 +0.40 respectively in control group (P>0.05). 4. At fourteen days after surgery Ag-NORs was 5.02+1.00% in test group and was 5.24+0.84% in control group (P>0.05). At fourteen days after surgery CD4+, CD8+and CD4VCD8+ were 41.6 + 8.6%, 35.4+12.7%, 1.23 + 0.36 respectively in test group, and 40.3 + 7.9%, 35.1+ 12.4%, 1.15 + 0.29 respectively in control group (P>0.05). 5. At forty days after surgical operation Ag-NORs was 5.84 + 0.91% in test group, and 5.81+0.77% in control group (P>0.05); CD4+, CD8+ and CD4VCD8+ were 47.7 + 4.8%, 30.2+5.6%, 1.61+0.26 respectively in test group and 46.3?.8%, 27.7 + 6.3%, 1.73 + 0.39 respectively in control group (P>0.05). 6. T lymphocyte Ag-NORs, CD4+, CD8+ and CD47CD8+ rose...
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