腹腔镜切除术配合FOLFOX4新辅助化疗对直肠癌患者血清FAS、Tu M2-PK及T细胞亚群的影响  

The influence of laparoscopic resection combined with FOLFOX4 neoadjuvant chemotherapy on serum FAS,Tu M2-PK and T cell subsets in patients with rectal cancer

作　　者：王俊伟[1] 金心富[1] 卢凯 WANG Jun-wei;JIN Xin-fu;LU Kai(Department of General Surgery,The 4th People's Hospital of Zigong City,Zigong Sichuan 643000,China.)

机构地区：[1]自贡市第四人民医院普外科,四川自贡643000

出　　处：《临床和实验医学杂志》2019年第9期981-985,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨腹腔镜切除术配合FOLFOX4新辅助化疗对直肠癌患者血清脂肪酸合成酶(FAS)、肿瘤型M2丙酮酸激酶(Tu M2-PK)及T细胞亚群的影响。方法前瞻性选择2011年1月至2013年1月在自贡市第四人民医院接受治疗的98例直肠癌患者,根据随机数字表法将其分为对照组和观察组,每组各49例。观察组患者采取FOLFOX4新辅助化疗方案配合腹腔镜手术治疗及术后化疗方案。对照组采取腹腔镜手术及术后化疗。观察两组患者的手术时间、术中出血量、术后下床时间以及肛门首次排气时间。两组患者入院时、术后化疗结束后1个月、3个月、6个月内对癌胚抗原(CEA)、糖类抗原199(CA199)转阴率。比较两组患者入院时、术后化疗1个月、3个月、6个月血清FAS、Tu M2-PK水平、T细胞亚群等变化。结果两组患者手术时间、术后首次下床时间、肛门排气时间以及术中出血量,差异均无显著性(P> 0. 05)。观察组患者在术后化疗结束后1个月、3个月、6个月的CEA和CA199转阴率分别均显著高于对照组(P <0. 05)。与对照组相比,观察组术后化疗结束后1个月、3个月、6个月的血清FAS和Tu M2-PK水平均显著更低,差异具有统计学意义(P <0. 05)。术后化疗1个月、3个月、6个月后两组患者组间血清T细胞亚群水平比较,差异均无统计学意义(P> 0. 05)。与本组化疗前相比,观察组术前化疗结束后,患者血清CD4+细胞比率显著下降,CD8+细胞比率明显升高,CD4+/CD8+值明显降低,差异具有统计学意义(P <0. 05)。结论腹腔镜切除术配合FOLFOX4新辅助化疗有利于增加直肠癌患者的疗效,并降低患者术后血清FAS、Tu M2-PK水平,患者的T淋巴细胞亚群功能在术后将会逐渐改善,是一种安全、有效的治疗方法。Objective To observe the influence of laparoscopic resection combined with FOLFOX4 neoadjuvant chemotherapy on serum FAS,Tu M2-PK and T cell subsets in patients with rectal cancer.Methods 98 cases of patients with rectal cancer in our hospital from From January 2012 to January 2014 were selected.According to the principle of complete randomization,patients were divided into observation group and control group.Patients in the observation group were treated with FOLFOX4 neoadjuvant chemotherapy,laparoscopic surgery and postoperative chemotherapy.Control group performed laparoscopic surgery and postoperative chemotherapy.The operation time,intraoperative blood loss,postoperative bedtime,and first anal exhaust time of the anus were observed.The conversion rate of carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)were compared between the two groups at the time of admission at 1 month,3 months and 6 months after the end of postoperative chemotherapy.The curative effect,serum FAS,Tu M2-PK level and T cell subsets of the two groups were observed.Results There were no significant differences in the operation time,the first time to get out of bed,the time of anal exhaust,and the amount of intraoperative blood loss in the two groups(P>0.05).The positive rate of CEA and CA199 in the observation group was significantly higher than that in the control group at 1 month,3 months,and 6 months after the end of postoperative chemotherapy(P<0.05).Compared with the control group,serum FAS and Tu M2-PK levels were significantly lower in the observation group after 1 month,3 months,and 6 months after the completion of postoperative chemotherapy.The difference between the two groups was significant(P<0.05).There was no significant difference in serum T cell subsets between the two groups after 1 month,3 months and 6 months after chemotherapy(P>0.05).After the preoperative chemotherapy in the observation group,the serum CD4+cell ratio decreased significantly,the CD8+cell ratio increased significantly,and the CD4+/CD8+value

关 键 词：直肠癌 腹腔镜切除术 FOLFOX4新辅助化疗 脂肪酸合成酶 肿瘤型M2丙酮酸激酶 T细胞亚群 

分 类 号：R735.37[医药卫生—肿瘤]