CT引导下射频消融联合靶向治疗对中晚期非小细胞肺癌患者免疫功能的影响  

Effect of radiofrequency ablation guided by CT combined with targeted therapy on immune function of patients with lung cancer

作　　者：赵跃萍[1] 苏宏[1] 孙萌萌[1] 吕文君[1] 梁园园[1] 吴蕾[1] 戴红[1] 袁菲阳 张珊珊[1] 杨光[2] 

机构地区：[1]武警辽宁总队医院内科,辽宁沈阳110034 [2]中国医科大学附属第一医院胸外科,辽宁沈阳110031

出　　处：《武警后勤学院学报（医学版）》2016年第2期114-118,共5页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】研究CT引导下射频消融联合靶向治疗对中晚期非小细胞肺癌患者免疫功能的影响。【方法】将80例诊断为中晚期非小细胞肺癌的患者随机分为对照组与观察组,每组40例。两组患者均给予吉非替尼联合顺铂与紫杉醇靶向治疗,观察组在靶向治疗的基础上行在CT与超声引导下经皮射频消融术,治疗前及治疗后4周测定细胞免疫及体液免疫功能并进行比较。【结果】治疗后观察组患者血清CD3[(64.53%±6.53%)vs(58.67%±4.54%)]、CD4[(39.48%±4.13%)vs(35.32%±3.43%)]、自然杀伤细胞[(23.65%±2.87%)vs(21.74±1.84%)]、Ig G[(16.32±1.21)g/L vs(14.64±1.32)g/L]、Ig M[(2.12±0.19)g/L vs(1.81±0.16)g/L]、Ig A[(2.78±0.33)g/L vs(2.59±0.16)g/L]浓度与CD4/CD8(1.47±0.18 vs 1.22±0.15)较治疗前有所升高(P<0.05),CD8[(23.43%±2.78%)vs(27.54%±2.21%)]较治疗前有所降低(P<0.05)、而对照组上述指标与观察组相反;治疗后观察组患者血清CD3[(64.53%±6.53%)vs(55.32%±5.43%)]、CD4[(39.48%±4.13%)vs(30.43%±3.09%)]、CD4/CD8(1.47±0.18 vs 1.14±0.14)、NK[(23.65%±2.87%)vs(17.54%±1.67%)]、Ig G[(16.32±1.21)g/L vs(11.22±0.65)g/L]、Ig M[(2.12±0.19)g/L vs(1.56±0.21)g/L)、Ig A[(2.78±0.33)g/L vs(2.34±0.31)g/L]高于对照组(P<0.05),观察组CD8[(23.43%±2.78%)vs(29.32%±2.78%)]较对照组低(P<0.05)。【结论】中晚期肺癌患者接受射频消融术联合靶向治能很好的改善免疫功能,是一种安全可靠且创伤较小的治疗方法,有很好的临床应用前景。【Objective】To study the effect of radiofrequency ablation guided by CT combined with targeted therapy on immune function of patients with non-small cell lung cancer in stage Ⅲ and Ⅳ.【Method】A total of 80 patients with non-small cell lung cancer in stageⅢ and Ⅳ were randomly divided into control group and observation group（40 patients per group）. All of them were treated with gefitinib combined with cisplatin and paclitaxel. Based on the targeted therapy, patients in observation group were treated with percutaneous radiofrequency ablation guided by CT and ultrasound. The functions of cellular immunity and humoral immunity were determined and compared between the two groups before and 4 weeks after the treatment.【Results】In the observation group, the serum concentrations of CD3[（64.53%±6.53%） vs（58.67%±4.54%）], CD4[（39.48%±4.13%） vs（35.32%±3.43%）], natural killer cell（NK） [（23.65%±2.87%） vs（21.74%±1.84%）], Ig G[（16.32±1.21） g/L vs（14.64±1.32） g/L], Ig M[（2.12 ± 0.19） g/L vs（1.81 ± 0.16） g/L] and Ig A[（2.78±0.33） g/L vs（2.59±0.16） g/L] as well as CD4/CD8[（1.47±0.18） vs（1.22±0.15）] after the treatment were higher than those before the treatment（P〈0.05）, while the concentration of CD8[（23.43%±2.78%） vs（27.54%±2.21%）]were lower than that before the treatment（P〈0.05）. However, those indications were adverse in the control group. After the treatment, the concentrations of CD3[（64.53%±6.53%） vs（55.32%±5.43%）], CD4[（39.48%±4.13%） vs（30.43%±3.09%）], NK[（23.65%±2.87%） vs（17.54%±1.67%）], Ig G [（16.32±1.21） g/L vs（11.22±0.65） g/L], Ig M [（2.12±0.19） g/L vs（1.56±0.21） g/L] and Ig A[（2.78±0.33） g/L vs（2.34±0.31） g/L] as well as CD4/CD8[（1.47±0.18） vs（1.14±0.14）] in the observation group were higher than those in the control group（P〈0.05）, while the concentration of CD8[（23.43%±2.78%） vs（29.32%±2.78%）] in the observation group

关 键 词：CT引导 导管消融术 非小细胞肺癌 靶向治疗 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]