乳腺癌保乳术后同步放化疗对患者机体免疫力的影响  

Impact of immunity during chemo-radiotherapy after breast conserving surgery

作　　者：李莉[1] 王建军[1] 

机构地区：[1]云南省第一人民医院乳腺甲状腺肿瘤外科,昆明650000

出　　处：《中华普外科手术学杂志（电子版）》2015年第6期20-22,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的分析和探讨乳腺癌保乳术后同步放化疗的临床疗效及对患者机体免疫力的影响。方法选取2010年7月至2011年7月80例乳腺癌患者,随机分为两组。化疗^+放疗组40例患者均在进行乳腺癌保乳术后给予放疗和化疗,单纯放疗组40例患者均在进行乳腺癌保乳术后单纯给予放疗。选取SPSS 19.00软件包开展数据统计分析,免疫指标以均数±标准差(±s)表示,t检验;两组患者的复发率、转移率、生存率、不良反应率等数据,应用χ~2检验;P<0.05差异有统计学意义。结果化疗^+放疗组的复发率7.5%,转移率10.0%,均低于单纯放疗组复发率27.5%,转移率17.5%;化疗^+放疗组3年生存率97.5%高于单纯放疗组87.5%;经统计学分析差异均有统计学意义,两组局部复发率、远处转移率、3年生存率的χ~2值分别为8.489、6.436、5.321,(P<0.05)。两组患者CD3^+、CD4^+、CD8^+、自然杀伤细胞(NK)对比,化疗^+放疗组患者均优于单纯放疗组患者,t值分别为2.456、3.021、2.983、2.321。化疗^+放疗组与单纯放疗组的恶心、呕吐,血小板减少,血细胞下降,放射性皮炎分别为11例、9例、7例、7例和20例、14例、12例、16例。两组患者的χ~2值分别为7.345、6.312、5.401和5.785,差异具有统计学意义(P<0.05)。结论早期乳腺癌保乳术后辅以放疗同步化疗这种常用的综合治疗模式能够有效的治疗乳腺癌患者,降低了患者病死率,是治疗早期乳腺癌的有效方法。Objective To investigate the clinical efficacy of breast conserving surgery combined with concurrent chemo-radiotherapy and its impact on patient＇s immunity. Methods Eighty patients with breast cancer treated from July 2010 to July 2011 in our hospital were randomly divided into two groups： observation group and control group. The observation group consisting of 40 patients who received breast conserving surgery was given both radiotherapy and chemotherapy,whereas the control group consisting of 40 patients who underwent breast conserving surgery was given radiotherapy alone. Statistical analysis of the data was performed by using SPSS 19. 00 software. Immune indexes were expressed as mean strain ratio ± standard deviation. The recurrence rate,metastasis rate and survival rate,and the adverse reactions of the two groups were compared by using the Chi-square test. P〈0. 05 was considered statistically significant. Results The recurrence rate of7. 5% and the transfer rate of 10. 0% in the observation group were lower than those in the control group respectively. The recurrence rate was 27. 5%,the transfer rate 17. 5%,and the 3-year survival rate 97. 5%in the observation group,which were higher than those in the control group（ P〈0. 05）. The local recurrence and distant metastasis rate,Chi-square value,3-year survival rate were 8. 489,6. 436,5. 321 respectively（ P〈0. 05）. CD3~＋,CD4~＋,CD8~＋,NK cells were superior in chemo-radiotherapy patients to those in radiotherapy patients. Nausea,vomiting,thrombocytopenia,decreased blood cells,radiation dermatitis were noted in patients receiving chemotherapy plus radiotherapy and in those receiving radiotherapy respectively.Conclusion Early breast conserving surgery followed by radiotherapy combined with concurrent chemotherapy is effective in treating early breast cancer,while reducing the mortality rate.

关 键 词：乳腺肿瘤 乳房切除术 改良根治性 综合疗法 免疫 

分 类 号：R737.9[医药卫生—肿瘤]