恒温热灌注联合常规化疗对老年胃癌术后病人免疫功能、相关因子及生存情况的影响  

Effects of thermostatic perfusion combined with conventional chemotherapy on the levels of immune function,related factors and survival state in elderly patients with gastric cancer after operation

作　　者：陈铁[1] 江晓晖[1] 高志斌[1] 朱汉达[1] 徐爱兵[1] 吴金东[1] 曹广鑫[1] 张学良[1] 王鼎[1] 刘浩锋 CHEN Tie;JIANG Xiao-hui;GAO Zhi-bin;ZHU Han-da;XU Ai-bing;WU Jin-dong;CAO Guang-xin;ZHANG Xue-liang;WANG Ding;LIU Hao-feng(Department of General Surgery,Nantong Cancer Hospital,Nantong 226000,China)

机构地区：[1]南通市肿瘤医院普外科,江苏省南通市226000

出　　处：《实用老年医学》2020年第3期254-257,共4页Practical Geriatrics

摘　　要：目的探究恒温热灌注联合常规化疗对老年胃癌术后病人免疫功能、相关因子及生存情况的影响。方法回顾性分析2012年5月至2015年3月收治的86例进展期胃癌术后病人的资料,并分为2组,对照组42例,为术后常规静脉化疗的病人;观察组44例,为术后腹腔恒温热灌注+常规静脉化疗的病人。比较2组病人治疗前后免疫功能、相关因子及肿瘤标记物的水平变化,并分析2组病人1年、3年生存率。结果化疗后,对照组的CD4^+、CD8^+、CD4^+/CD8^+与化疗前差异无统计学意义(P>0.05),血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、癌胚抗原(CEA)及糖蛋白抗原19-9(CA19-9)水平明显低于化疗前(P<0.05);观察组的CD4^+、CD4^+/CD8^+明显高于化疗前及对照组(P<0.05),CD8^+、VEGF、MMP-9、CEA及CA19-9水平明显低于化疗前及对照组(P<0.05)。观察组化疗后3年生存率显著高于对照组(75.00%比50.00%,P<0.05)。结论腹腔恒温热灌注化疗联合常规静脉化疗可有效改善胃癌术后病人的免疫功能,抑制肿瘤血管的生长,延长病人的生存时间。Objective To investigate the effects of thermostatic perfusion combined with conventional chemotherapy on the levels of immune function,related factors and survival in the elderly patients with gastric cancer after operation.Methods A retrospective analysis was performed on the clinical 86 elderly patients with advanced gastric cancer after operaction from May 2012 to March 2015.The patients were divided into two groups,control group(n=42)treated with routine intravenous chemotherapy,observation group(n=44)treated with thermostatic perfusion after the operation combined with conventional intravenous chemotherapy.The levels of immune function,related factors and tumor markers before and after chemotherapy,and the 1-year and 3-year survival rates were compared between the two groups.Results After chemotherapy,there were no significant differences in the levels of CD4^+,CD8^+,CD4^+/CD8^+ in the control group compared with those before chemotherapy(P>0.05),and the levels of vascular endothelial growth factor(VEGF),matrix metalloprotein-9(MMP-9),carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)in the control group were significantly lower than those before chemotherapy(P<0.05).The levels of CD4^+,CD4^+/CD8^+ were significantly higher and the levels of CD8^+,VEGF,MMP-9,CEA and CA19-9 were significantly lower in the observation group than those before chemotherapy and the control group(P<0.05).The 3-year survival rate of the observation group was significantly higher than that of the control group(75.00% vs 50.00%,P<0.05).Conclusions Intraperitoneal thermostatic perfusion chemotherapy combined with conventional intravenous chemotherapy can improve the immune function,inhibit the growth of tumor vessels,prolong the survival time in the elderly patients with gastric cancer after operation.

关 键 词：恒温热灌注 常规化疗 老年人 术后 胃癌 免疫功能 

分 类 号：R735.2[医药卫生—肿瘤]