不同化疗方案对乳腺癌患者免疫功能及部分生活质量的影响  

Influence of different chemotherapies on the immunological function and part of the quality of life of patients with breast cancer

作　　者：殷雷[1] 齐燕[1] 苗鑫[1] 李湘奇[1] 党相国[1] 

机构地区：[1]泰山医学院附属医院乳腺外科,山东省泰安市271000

出　　处：《中国综合临床》2017年第6期481-484,共4页Clinical Medicine of China

基　　金：国家自然科学基金（81473687）;山东省自然科学基金（ZR2009CM039,ZR2013HM038）;山东省医药卫生科技发展计划项目（201iHW084）;泰安市科学技术发展计划项目（2015Ns2082）

摘　　要：目的 探讨TAC（多西他赛、吡柔比星、环磷酰胺）、AC-T（吡柔比星、环磷酰胺序贯多西他赛）方案化疗对乳腺癌患者外周血T细胞亚群和NK细胞及部分生活质量的影响.方法 选取2015年1-12月我院收治的66例乳腺癌患者临床资料,其中31例采用TAC方案化疗6周期、35例采用AC-T方案化疗8周期,分别采集化疗前和末次化疗结束后的外周血,流式细胞技术检测外周血中T细胞亚群、NK细胞的比例,并比较化疗前、后患者部分生活质量的变化.结果 66例患者化疗后外周血中CD3＋、CD3＋CD4＋、NK细胞[分别为（68.58±11.03）％、（33.53±8.84）％、（18.27±10.65）％]均显著低于化疗前[分别为（74.03±13.04）％、（38.42±9.79）％、（19.83±10.19）％],差异均有统计学意义（t值分别为4.296、3.387、4.092,P均＜0.05）.TAC方案化疗后外周血CD3＋、CD3＋ CD4＋、CD3＋ CD8＋T细胞及Karnofky评分[分别为（64.63±10.01）％、（31.19±7.41）％、（24.66±7.40）％、（68.63±5.10）分]均显著低于AC-T方案[分别为（72.29±10.78）％、（35.74±9.60）％、（30.15±11.12）％、（77.29±4.58）分],差异均有统计学意义（t值分别为2.99、2.15、2.35、2.237,P均＜0.05）;CD3＋CD4＋/CD3＋ CD8＋T细胞及NK细胞均有不同程度降低,但差异均无统计学意义（P均＞0.05）.66例患者化疗后体质量较化疗前轻度增加,但差异无统计学意义.结论 化疗药物对患者的免疫功能及部分生活质量造成不同程度的影响,TAC方案较AC-T方案更易降低患者的免疫功能及部分生活质量.Objective To explore the influence of TAC protocol （pirarubicin,cyclophosphamide and docetaxel） and AC-T protocol （pirarubicin,cyclophosphamide and sequential docetaxel） on T lymphocytes cell subsets （included CD3＋ T cells,CD3＋ CD4＋ T cells,CD3＋ CD8＋ T cells,CD3＋ CD4＋/CD3 ＋ CD8＋）,natural killer （NK） cells and part of the quality of life in the peripheral blood of patients.Methods A total of 66 patients with breast cancer included 31 cases for TAC protocol （6 cycles of chemotherapy） and 35 cases for AC-T protocol（8 cycles of chemotherapy）.Collected respectively before and after the last chemotherapy of peripheral blood,used flow cytometry technique to detect the proportion of T cell subsets and NK cells in peripheral blood,and compared the change of the part of the quality of life before and after chemotherapy.Results After chemotherapy of total of 66 patients CD3＋ T cells,CD3＋ CD4＋T cells and NK cells of peripheral blood （（68.58± 11.03） %,（33.53 ± 8.84） %,（18.27 ± 10.65） %） significantly lower than before chemotherapy （（74.03±13.04）%,（38.42±9.79）%,（19.83± 10.19）%）,the differences were statistically significant（t =4.296,3.387,4.092,P〈 0.05）.Grouping was TAC protocol with AC-T,T cell subsets and NK cells before chemotherapy differences had no statistical significance.But after chemotherapy,CD3＋ T cells,CD3＋ CD4＋T cells,CD3＋CD8＋ T cells and Karnofky score（（64.63±10.01）%,（31.19±7.41）%,（24.66±7.40）%,（68.63± 5.100）%） of peripheral blood on TAC protocol were more decreased than AC-T protocol（（72.29± 10.78）%,（35.74± 9.60） %,（30.15 ± 11.12） %,（77.29 ± 4.58） %）,the differences were statistically significant （t =2.99,2.15,2.35,2.237,P〈0.05）.CD3＋ CD4＋/CD3＋ CD8＋ and NK cells were also decreased,but without statistical significance.The body quality of 66 patients was slightly increased after chemotherapy,but without statistical significance.Conclusion The body＆#39

关 键 词：乳腺癌 化学治疗 T细胞亚群 NK细胞 生活质量 

分 类 号：R737.9[医药卫生—肿瘤]