A Clinical Research About The Different Frequency Of Peripheral Blood T Lymphocytes Subsets And C-reactive Protein Before And After The Comprehensive Treatment Of The Renal Cancer

Renal cell carcinoma(Rcc)is the most common malignant tumor in Urology, its incidence in recent years there have been an increasing tendency, with the imaging examination and technological progress, the proportion of early non-metastatic renal cell carcinoma increased. radical nephrectomy is the preferred treatment, but after a recurrence and metastasis may be about 40-70% of the patients with distant spread of metastatic carcinoma. Long-term clinical practice found that the traditional radiotherapy, chemotherapy and hormone therapy for the treatment of tumor recurrence and metastasis and poor preventive effect. RCC is immune endogenous. At present study found that immunotherapy better, and increase the survival rate. The anti-tumor effect is cell-mediated immunity, the immune cells which directly reflect the state of the anti-tumor immunity. It always be as an important indicator of Postoperative prognosis for the tumor patients. CD4+ T cell subset always be as a helper T cell, can produce cytokines such as IL-2, INF etc.which mediate the cytotoxic effector cells reaction and phagocytic function, but also assisted B cells to produce antibodies to participate in humoral immunity. CD8 + T cell subset lines cytotoxic T lymphocyte / supptessor cell, is the anti-tumor effect of the main cells. Therefore monitoring of peripheral blood T-cell subsets can be used to a indicator to reflect the changes in the body's immune capacity. In chemotherapy-immune therapy ,the early peripheral blood CD4+T lymphocytes/CD8+T lymphocytes ratio increased is a strong independent prognostic factor. In addition, C-reactive protein (CRP) levels in the tumor-infiltrating plasma will be at significantly increased rapidly, and with the vesting of the disease show various degrees decline, and its role related increasing Macrophages,TNF-аand MCP-1 standard, it can be used for clinical diagnosis of RCC, condition assessment and treatment activities of the judgement, is an independent prognostic factor for the RCC. CD4 +CD25 + regulatory T cells (Treg) is a specific phenotype and the inhibition function of T cell leaching Baya groups, through various means, inhibit anti-tumor immune from the boot of the stage, play an important role to totumor escape . Regulatory T cells in Tumor patients increased, is not only a universal phenomenon, but also for prognosis and Evaluation and has great guiding significance of the new immune therapy,and an effective target. Such research for clinical treatment of renal cell carcinoma have a realistic guiding significance.The purpose of this issue is through understandingаinterferonα(INF-α), interleukin-2 (IL-2) and 5-fluorouracil (5-FU)jointly applied to RCC patients after radical nephrectomy observed before and after application of lymphocyte subsets including the regulatory T cells and the changes of CRP levels in plasma, to understand the effect of Immunotherapy for the treatment of renal cell carcinoma. As in the case of many hospitals collected, it belongs to the multi-center prospective study of the before and after control. Major research methods and results are as follows:1 Choose Object Observation:Choose Bethune International Peace Hospital urology, Fourth Hospital of Hebei Medical University urology two of the Test Center, since January 1, 2007, starting from the hospital radical nephrectomy in patients with preoperative selected by ultrasound, CT and MRI, the diagnosis of unilateral renal mass, a few specimens of 30 patients. Including 17 male and 13 females, aged 18-78 years, with an average age of 60.3. The pathology report after nephrectomy are clear cell renal cell carcinoma all. AJCC phases: PhaseⅠ2 cases,Ⅱ15 cases, 10 cases of stageⅢ,Ⅳthree cases. Tumor diameter 1.8 to 16cm, and an average of 6. 7cm. 2 Comprehensive treatment2.1 Radical nephrectomy:Resection of the week, including renal fascia, kidney-fat, kidney, renal week lymph nodes, ipsilateral adrenal gland, on the 1 / 2 ureteral, exploratie regional lymph nodes, if suspicious involvement, implementation limitations to the regional lymph node dissection;2.2 Immunotherapy:After one week after the incision healed by the start of the programme the following line immune therapyThe programme cycle eight weeks, 3 months interval can be repeated. Each treatment cycle. IFN–αtotal dose of 72 MIU, IL-2 total dose of 126 MIU.2.3 Monthly review after radical nephrectomy blood Conventional, liver and kidney function, liver and kidney B-ultrasound, chest X-ray and bone. According during treatment to patients with symptomatic treatment accordingly.3 Observation of indicators and statistical analysis Patients are located within one week before the surgery, and one week after application of an immune therapy treatment (eight weeks) for the three observation points3.1 Patients were taken in the three observation points 3 ml of whole peripheral blood, thruogh scattering turbidimetric method to measurement CRP values and made it as the before and after autologous control variables;3.2 Patients were taken in the three observation points 1 ml of whole peripheral blood with EDTA-anticoagulant.Using flow cytometry to measurement the T-lymphocyte subsets and immune markers in patients with records of CD3+,CD4+,CD8+,CD4+/CD8+ such as data value as control variables before and after autologous;3.3 Patients were taken in the three observation points EDTA-1 ml of whole peripheral blood ,and use it thruogh flow cytometry to counts the CD4+ CD25+ T lymphocytes (Treg cells) as control variables before and after autologous.Statistical analysis: the variable distribution of information matching,students t-test, or Wilcoxon test.4.Results: The study showed that 30 cases of patients with a clear diagnosis of RCC after 9w comprehensive treatment , CRP levels in the peripheral blood before treatment significantly reduced;peripheral blood T-lymphocyte subsets of the CD3+ cells increased significantly, CD3+CD4+T cells did not change significantly, CD3+CD8+T cells decrased significantly, CD4+/CD8+rate was significantly increased; Treg cells decreased significantly.This study was observed in RCC patients before and after comprehensive treatment the biochemical and lymphocyte subsets indices of peripheral blood changes revealed that With Interferonα(IFN-α), Interleukin-2 (IL-2) and 5-FU Joint applied renal after radical resection of cancer patients, there is an obvious difference in their immune function and CRP level before and after applicationcan be summed up by analyzing comprehensive treatment in the effectiveness of treatment of patients with RCC, which may provide guidance for clinical treatment.