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目的：评价成骨肉瘤患者临床分期与免疫学变化的关系及意义。方法：利用流式细胞仪检测120例成骨肉瘤患者淋巴细胞亚群、利用MTT法检测NK细胞活性，应用放射免疫分析法检测IL－2、TNF－α、β2－微球蛋白的变化，应用ELISA法检测SIL－2R的改变。结果：随着Enecking分期的增高，患者NK活性、CD4、CD4／CD8、IL－2逐渐下降，CD8、sIL－2R、β2－MG、TNF－α逐渐升高P＜0．01；Ⅱa期成骨肉瘤患者机体免疫功能活跃，CD3、CD4、NK活性及IL－2、sIL－2R高于对照组P＜0．01，其余指标与对照组相同；Ⅰb及Ⅱb组患者各项指标改变明显；Ⅲ期肿瘤CD4、CD4／CD8、IL－2较Ⅱ期明显降低sIL－2R、TNF－α急剧升高P＜0．01。结论：成骨肉瘤患者免疫功能与疾病分期呈负相关，淋巴细胞亚群、sIL－2R、IL－2可作为监测患者病情改变的指标。
Objective: To evaluate the relationship between clinical stage and immunological changes in osteosarcoma patients and its significance. Methods: The lymphocyte subsets of 120 osteosarcoma patients were detected by flow cytometry. The activity of NK cells was detected by MTT assay. The changes of IL-2, TNF-α and β2-microglobulin were detected by radioimmunoassay. The change of SIL-2R was detected by ELISA. RESULTS: With the increase of Enecking staging, the NK activity, CD4, CD4/CD8, and IL-2 levels were gradually decreased, and CD8, sIL-2R, β2-MG, and TNF-α were gradually increased (P<0.01); IIa The immune function of patients with osteosarcoma was active. The activity of CD3, CD4, NK and IL-2, sIL-2R were higher than those of the control group (P<0.01). The other indexes were the same as those of the control group; the patients of the Ib and IIb groups were various. The indexes changed significantly; in stage III tumors, CD4, CD4/CD8, and IL-2 levels were significantly lower than those in stage II; sIL-2R and TNF-alpha levels increased dramatically (P<0.01). Conclusion: The immune function of osteosarcoma patients is negatively correlated with disease stage. Lymphocyte subsets, sIL-2R and IL-2 may be used as indicators for monitoring the patient’s condition changes.