放化疗联合热疗治疗中晚期宫颈癌的疗效及对CD4~＋T细胞平衡失调的影响  

Effect of synchronization of thermotherapy and chemoradiotherapy on cervical cancer in middle and late stage and CD4^+T cells dysequilibrium

作　　者：杨晓杰[1] 范凌霞[1] 宋俊霞[1] 谢娅[2] 

机构地区：[1]河南省焦作市焦作煤业（集团）有限责任公司中央医院,河南焦作454000 [2]郑州大学第一附属医院,河南郑州450000

出　　处：《现代中西医结合杂志》2016年第26期2871-2874,2878,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察同步热放化疗治疗中晚期宫颈癌的临床疗效及对体内CD4^+T细胞平衡失调的影响。方法将200例中晚期宫颈癌患者随机分为2组,同步放化疗组(CRT组)给予同步放化疗治疗,深部热疗加同步放化疗组(H+CRT组)在同步放化疗基础上给予盆腹腔深部局部热疗,比较2组临床疗效及生存期。同时选择同期健康体检女性100例作为健康对照组,检测健康对照组及CRT组、H+CRT组治疗前后外周血Th1、Th2、Th17、Treg细胞百分率及IFN-γ、Fox P3蛋白水平和IL-4、IL-17水平。结果 H+CRT组临床总有效率明显高于CRT组(P<0.05),生存期明显长于CRT组(P<0.05)。与健康对照组比较,宫颈癌患者外周血Th1细胞百分率、Th17/Treg比值及IFN-γ蛋白水平均明显降低(P均<0.05),Th17、Treg细胞百分率及Fox P3蛋白水平和IL-17、IL-4水平均明显升高(P均<0.05),虽然Th2细胞百分率与健康对照组比较差异无统计学意义(P>0.05),但是Th1/Th2比值明显低于健康对照组(P<0.05),出现Th1/Th2漂移。治疗后,Th1、Th2、Th17、Treg细胞百分率及IFN-γ、Fox P3蛋白水平和IL-4、I-17水平均明显恢复(P均<0.05),且H+CRT组各指标恢复程度明显优于CRT组(P均<0.05)。结论中晚期宫颈癌患者体内出现CD4^+T细胞平衡失调,热疗可以通过纠正CD4^+T细胞的水平达到抗肿瘤的目的。Objective It is to observe the clinical curative effect of synchronization of thermotherapy and chemoradiotherapy on eervieal cancer in middle and late stage and CD4 ＋ T cells dysequilibrium. Methods 200 patients with cervical cancer in middle and late stage were randomly divided into the CRT group and H ＋ CRT group, the CRT group was treated with traditional ehe- moradiotherapy, H ＋ CRT group were treated with abdominopelvie cavity deep local thermotherapy based on the therapeutic schedule of the CRT patients. The clinical curative effect and survival time between the two groups were compared. 100 women given physical examination were set as the control group. The levels of peripheral blood Thl, Th2, Thl7 and Treg cells, the con- centration of the relevant cytokines were detected in the three groups. Results The total effective rate was higher while survival time was longer in H ＋ CRT group than that in CRT group （P 〈 0.05 ）. Compared with eontrol group, Thl cells percentage and Th17/Treg and IFN-γlevel in peripheral blood were significantly lower in patients with cervical cancer, although the differ- ence in Th2 cell percentage was not significant （P 〉 0.05 ） , but Thl/Th2 was lower than that in control group （P 〈 0.05 ） , Thl/Th2 drift could be found. After the intervention, percentage of Thl , Th2, Thl7 and Treg cells recovered, the reeovery was more obvious in H ＋ CRT group than that in CRT group. Conclusion CD4 ＋ T cells dysequilibrium appears in the patients with middle and late stage cervical cancer, thermotherapy can achieve the purpose of anti-tumor by correeting the level of CD4 ＋ T cells.

关 键 词：宫颈癌 中晚期 CD4+T细胞 热疗 

分 类 号：R737.33[医药卫生—肿瘤]