[Postoperative Th1 and Th2 type cytokine changes in patients with esophageal squamous cell carcinoma and their clinical significance].

OBJECTIVE: To study the expressions of Th1 and Th2 type cytokines in patients with esophageal squamous cell carcinoma and the influence of operation on such expressions. METHOD: Enzyme-linked immunosorbent assay (ELISA) was used to detect Th1 (IL-2 and INF-gamma) and Th2 type cytokines (IL-4, IL-6 and IL-10) in cultured peripheral blood mononuclear cells (PBMCs, for 48 h) from 30 healthy controls and 46 esophageal squamous cell carcinoma patients (collected before and 8 and 30 d after operation, respectively). RESULTS: Compared with the control group, the expressions of Th1 type cytokines, IL-2 and INF-gamma, were significantly depressed in the PBMCs of the cancer patients (P<0.05), while expression of Th2 type cytokines, IL-6 was significantly enhanced (P<0.05), and IL-4 and IL-10 showed only slight enhancement. Such changes in the expressions of the cytokines showed a correlation with TNM (tumor-node-metastasis)stage of the tumors. After operation, the expressions of Th1 type cytokines increased and Th2 type cytokines decreased. CONCLUSIONS: Th1 cells are suppressed in patients with esophageal squamous cell carcinoma, while the function of Th2 cells is enhanced. Operation may reverse such changes, and dynamic detection of Th1 and Th2 type cytokines may indicate the prognosis, therapeutic effect and risks of relapse and metastasis.

[Technical improvement of mechanical suture of bronchial stumps in pneumonectomy].

OBJECTIVE: To prevent or reduce such postoperative complications of pneumonectomy as bronchopleural fistula and promote the curative effect of the surgery by improving the technique for handling the bronchial stumps. METHODS: In 107 patients, bronchial stapler was adopted for closure of the bronchial stump and pneumonectomy was subsequently performed on the side of the staples. A 1-0 polyester suture was used to for suture in the shape of "U" deep in the mechanical suture on the bronchial stump. The postoperative complications were observed. RESULTS: The operations were performed easily and the bronchial stumps were short and sutured firmly. No fluid retention or granuloma occurred in the stumps after the operation, nor were the complications such as intractable cough and infection of thoracic cavity observed. No bronchopleural fistula was found in these patients. CONCLUSION: This new method is safe and effective for treatment of the bronchial stumps.