NUTRITIONAL-STATUS AND THE NONSPECIFIC CELLULAR AND HUMORAL IMMUNE-RESPONSE IN ESOPHAGEAL-CARCINOMA
NUTRITIONAL-STATUS AND THE NONSPECIFIC CELLULAR AND HUMORAL IMMUNE-RESPONSE IN ESOPHAGEAL-CARCINOMA
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DOI：
10.1097/00000658-197904000-00015
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发表时间：
1979-01-01
影响因子：
9
通讯作者：
ANGORN, IB
中科院分区：
文献类型：
--
作者：
HAFFEJEE, AA;ANGORN, IB
在食管癌中，两个主要因素是有效的;两者都能够抑制免疫应答，即，饥饿和恶性肿瘤。对20例因不能切除的食管癌接受姑息性插管治疗的患者进行了研究。所有患者均患有蛋白质-热量营养不良，处于负氮平衡。在营养不良纠正前后，对淋巴细胞计数和非特异性细胞及体液免疫应答进行评价。未尝试减小肿瘤体积。所有患者的细胞免疫应答均受损。DNCB [二硝基氯苯]皮肤试验呈阴性，绝对淋巴细胞计数和[胸腺衍生]淋巴细胞数量显著降低，对植物血凝素（PHA）刺激的促有丝分裂反应显著降低。免疫球蛋白A水平显著升高，但血清补体[c]浓度正常。负N平衡的恢复导致绝对和T淋巴细胞数量的显着增加，并显着增加对PHA的促有丝分裂反应。DNCB试验仍无反应。营养补充也显著增加血清C3，C4和C3 PA浓度。负N平衡的恢复可能会逆转免疫轻瘫的体外证据，并产生C浓度的增加，而不减少肿瘤负荷的治疗。
In carcinoma of the esophagus, 2 major factors are operative; both are capable of suppressing the immune response, i.e., starvation and the presence of a malignant tumor. Patients (20) who were treated by palliative intubation for unresectable carcinoma of the esophagus were investigated. All patients were suffering from protein-calorie malnutrition and were in negative N balance. Lymphocyte counts and the nonspecific cellular and humoral immune response were evaluated before and after correction of the nutritional deficit. No attempt was made to reduce tumor bulk. The cellular immune response was compromised in all patients. The DNCB [dinitrochlorobenzene] skin test was negative, absolute lymphocyte counts and [thymus-derived]lymphocyte numbers were significantly depressed and the mitogenic response to phytohemagglutinin (PHA) stimulation significantly depressed. Immunoglobulin A levels were significantly elevated but serum complement [c] concentrations were normal. Reversal of the negative N balance resulted in a significant increase in absolute and T-lymphocyte numbers and a significant increase in the mitogenic response to PHA. The DNCB test remained nonreactive. Nutritional repletion also significantly increased serum C3, C4 and C3PA concentrations. Reversal of negative N balance may reverse in vitro evidence of immunoparesis and produce an increase in C concentrations, without therapeutic reduction in the tumor load.