同步放化疗对食管癌患者免疫功能及肿瘤标志物SCC-Ag、CYFRA21-1的影响  

Effects of concurrent chemoradiotherapy on immune function and tumor markers SCC-Ag and CYFRA21-1in patients with esophageal carcinoma

作　　者：金灵莉[1] 杜致远 卢光新[1] 吕飞[1] 尚瑞[1] 

机构地区：[1]十堰市人民医院消化内科,湖北十堰442000 [2]湖北医药学院信息网络中心,湖北十堰442000

出　　处：《海南医学院学报》2017年第16期2251-2254,共4页Journal of Hainan Medical University

基　　金：湖北省自然基金资助项目(816172)~~

摘　　要：目的:探讨同步放化疗和单纯放疗治疗食管癌对患者免疫功能以及肿瘤标志物鳞状上皮细胞癌抗原(SCC-Ag)、角蛋白19片段抗原21-1(CYFRA21-1)的影响。方法:选取2015年6月~2017年4月在本院进行治疗的食管癌患者84例随机分成对照组和观察组,每组各42例。其中对照组利用医用电子直线加速器进行单纯放疗,治疗时间6周;观察组在对照组放疗步骤相同的基础上给予同步化疗,化疗方案采用紫杉醇联合顺铂治法,3周为1个疗程,共化疗2个疗程。两组均于入院时以及单纯放疗/同步放化疗结束后翌日清晨采集空腹静脉血,采用流式细胞仪检测两组食管癌患者的免疫功能指标(T淋巴细胞(T总)、抑制性T细胞(Ts)、辅助性T细胞(Th)、Th/Ts以及自然杀伤细胞(NK))。利用电化学发光法检测血清SCC-Ag和CYFRA21-1的水平变化。结果:治疗前,两组患者各项免疫功能指标以及血清SCC-Ag、CYFRA21-1水平比较,无明显差异(P>0.05),治疗后两组患者T总比例、Th比例以及Th/Ts比值均较治疗前显著升高,而Ts比例显著减少,差异有显著性(P<0.05);NK高于治疗前,但差异无统计学意义(P>0.05)。治疗后组间比较,观察组T总比例、Th比例以及Th/Ts均明显高于对照组的相应水平(P<0.05),而两组NK、Ts比例差异不明显,差异无统计学意义(P>0.05)。治疗后,两组患者血清SCC-Ag、CYFRA21-1水平相较治疗前均明显减少(P<0.05);治疗后,观察组血清SCC-Ag、CYFRA21-1水平较对照组明显降低,差异有显著性(P<0.05)。结论:放疗同步顺铂+紫杉醇化疗可改善食管癌患者免疫功能,降低血清SCC-Ag、CYFRA21-1水平,有利于提高患者生存率。Objective：To investigate the effects of concurrent chemoradiotherapy and radiotherapy alone on immune function and tumor markers SCC-Ag and CYFRA21-1in patients with esophageal carcinoma.Methods：A total of 84 patients with esophageal cancer treated in our hospital from June 2015 to April 2017 were selected and randomly divided into observation group and control group,with 42 cases in each group.The patients in the control group received radiotherapy only and irradiated by medical electron linear accelerator and radiotherapy for 6weeks;while those who were in the observation group had been given by radiotherapy and chemotherapy concurrently for 2courses,with 3weeks for each course.The fasting venous blood of patients in two groups were collected in the morning when patients were hospitalized and after chemotherapy,using flow cytometry to detect the immune function indexes of two groups of patients with esophageal cancer before and after treatment,including natural killer cells（NK）,T suppressor cells（Ts）,T helper cells（Th）,Th/Ts and T lymphocytes（T total）.The levels of serum SCC-Ag and CYFRA21-1 were detected by electrochemiluminescence assay.Results：There were no significant differences in the indexes of immune function between the two groups before treatment（P〈0.05）.Total T,the proportion of Th and Th/Ts in the two groups were both significantly increased（P〈0.05）;the proportion of Ts were significantly decreased（P〈0.05）;NK was higher than treatment before but not significantly（P〈0.05）.After treatment,the levels of T total,Th,Th/Ts in the observation group were significantly higher than those in the control group（P〈0.05）;the levels of NK and Ts were not significantly different（P〈0.05）.Before treatment,there was no significant difference in serum SCC-Ag and CYFRA21-1between the two groups（P〈0.05）.After treatment,the serum SCC-Ag and CYFRA21-1levels of the two groups were both significantly decreased（P〈0.05）;the serum levels of SCC-Ag and CYFRA21-

关 键 词：放疗 化疗 食管癌 免疫功能 鳞状上皮细胞癌抗原(SCC-Ag) 角蛋白19片段抗原21-1(CYFRA21-1) 

分 类 号：R735.1[医药卫生—肿瘤]