中文摘要：

目的：研究晚期卵巢癌患者经一线化疗后体内CD8＋T细胞和NK细胞数量及功能的动态变化。方法：选取术后行紫杉醇联合卡铂化疗的晚期卵巢上皮癌患者共13例，采集化疗前（S0）、化疗后5～7天（S1）、化疗后12～14天（S2）和化疗后25～28天（S）外周血，流式细胞术检测患者外周血中CD3＋、CD4＋、CD8＋和NK细胞的百分比及绝对数量。采用体外自体肿瘤细胞裂解物脉冲淋巴细胞共培养的方法检测不同时间点CD8＋T细胞IFN-γ的分泌功能，并以LDH释放法测定NK细胞对K562细胞的杀伤活性。结果：在一个完整的化疗周期中，CD3＋、CD4＋、CD8＋细胞的绝对数目均于S，期降至最低点，且与S0期分别都有显著性差异。与对照组相比，当体外给予自身肿瘤细胞裂解物刺激诱导培养后，在S1、S2和S期产生IFN-γ的CD8＋细胞比例均较对照组显著增加，且CD8＋IFN-γ细胞比例在S2期达到最高。NK细胞的绝对数目于S1期降至最低点，且与S0期有显著性差异，NK细胞的比例及杀伤活性在化疗前、后均无显著性差异。结论：卵巢癌患者于一线化疗后机体经历免疫重建的过程，该过程中CD8＋T细胞介导的免疫应答一过性增高，而NK细胞的杀伤活性无明显变化。化疗后免疫重建期可能是免疫治疗实施的最佳窗口期。

英文摘要：

Objective： The propose of this study is to investigate the dynamic changes in the numbers and functions of CD8＋ T cells and NK cells in patients with advanced ovarian cancer undergoing first line chemotherapy, so as to identify whether there was a ＂window period＂ of anti-tumor immune suppression reverse after chemotherapy. Methods： Peripheral blood samples from each ovarian cancer patient were obtained before （S0） and at day 5-7 （ S1 ）, day 12-14 （ S2 ） and day 25-28 （ S3 ） after chemotherapy in i 3 patients. The numbers and proportions of CD3 ＋, CD4＋, CD8 ＋ and nature killer （NK） cells were analyzed by flow cytometry technique. The percentages of specific IFN-T-secreting CD8＋ cells were also calculated after that peripheral lymphocytes had been stimulated with self tumor lysates. Cytotoxicity of NK cells against K562 cells was detected by LDH releasing assay. Results： The numbers of CD3 ＋, CD4＋ , CD8＋ T cells and NK cells reduced to the lowest on S1. Compared to those of the control group, and the percentages of IFN-T-secreting CD8 ＋ T cells were remarkably higher on S1, S2 and S3 when CD8＋ T cells were stimulated with autolbgous tumor antigen, and the percentage of CD8＋ ;IFN-γ＋ cell reached the highest on S2. No significant differences of NK cell cytotoxicity against K562 cells were found on S1, S2 and S3 compared to SO. Conclusion： Paclitaxel and carboplatin induce lymphopenia, which triggers the temporary immune reconstitution. During immune reconstitution the enhanced priming of CD8 ＋T cell response by autologous tmnor antigen is found while the function of NK cells does not change significantly. It probably turns out that the ＂window period＂ during immune reconstitution offers a best opportunity for cancer immunotherapy.