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目的研究表明西米替丁(CIM)能增强胃肠癌患者机体的免疫力,本实验探讨了CIM对结直肠癌(CRC)肿瘤浸润淋巴细胞(TIL) 及肿瘤间质细胞HLA-DR表达的影响,以了解CIM在CRC局部免疫中的作用。方法将49例CRC随机分为治疗组与对照组,治疗组25例术前1周开始口服CIM；对照组进行常规治疗,不服用CIM；手术前后比较肿瘤间质TIL浸润程度及HLA-DR表达的变化。结果 CIM治疗组手术前后TIL的明显反应,由治疗前的32％(8／25)上升到治疗后的76％(19／25),差别有显著性(P＜0.005)；而对照组仅由治疗前的25％(6／24)上升至33％(8／24),无显著统计学差异。治疗组HLA-DR的高表达由治疗前的36％(9／25)上升到治疗后的72％(18／25),有显著差异性,而对照组由41.7％(10／24)上升至45.8％(11／24),无显著差异(P＞0.50)。结论术前应用CIM能增加CRC患者肿瘤组织TIL的浸润及增强间质细胞HLA-DR的表达,表明CIM能增加CRC患者的局部抗肿瘤免疫力。
Objective Studies have shown that cimetidine (CIM) can enhance the body immunity of patients with gastrointestinal cancer. This study investigated the effect of CIM on the expression of HLA-DR in tumor infiltrating lymphocytes (TILs) and tumor stromal cells of colorectal cancer (CRC) To understand the role of CIM in local immunotherapy of CRC. Methods Forty-nine CRC patients were randomly divided into treatment group and control group. Twenty-five patients in the treatment group received oral CIM 1 week before operation. The control group received routine treatment without CIM. Tumor infiltration and HLA-DR expression were compared before and after operation The change. Results The significant response of TIL before and after operation in CIM group increased from 32% (8/25) before treatment to 76% (19/25) after treatment, the difference was significant (P <0.005) Before treatment, 25% (6/24) increased to 33% (8/24), with no significant statistical difference. The high expression of HLA-DR in treatment group increased from 36% (9/25) before treatment to 72% (18/25) after treatment, which was significantly different from that in control group from 41.7% (10/24) to 45.8% (11/24), no significant difference (P> 0.50). Conclusion Preoperative CIM can increase the infiltration of TIL in tumor tissue and increase the expression of HLA-DR in stromal cells, suggesting that CIM can increase the local anti-tumor immunity in CRC patients.