局部进展期直肠癌围放疗期外周血免疫功能指标的变化  

A clinical observational study of the changes of immune functional indexes in the peripheral blood of patients with locally advanced rectal cancer during perioperative period of radiotherapy

作　　者：陈若 沈琦 罗文广[1] 雕丽琼[1] 张红雁[1] Chen Ruo;Shen Qi;Luo Wenguang;Diao Liqiong;Zhang Hongyan(Department of Radiation Oncology,Anhui Provincial Hospital,Hefei 230001,China)

机构地区：[1]安徽医科大学附属省立医院、安徽省立医院肿瘤放疗科,合肥230001

出　　处：《中国临床保健杂志》2020年第3期377-380,共4页Chinese Journal of Clinical Healthcare

基　　金：肿瘤免疫与营养治疗安徽省重点实验室开放课题(2018AHZL01);“科大新医学”联合基金项目(wk9110000011)。

摘　　要：目的观察局部进展期直肠癌放疗前、放疗结束时及放疗结束后1月外周血免疫功能指标变化并分析围放疗期直肠癌患者免疫功能变化的临床意义。方法选择安徽省立医院2018年1月到2019年10月54例接受盆腔精确放射治疗的原发直肠腺癌患者,比较研究对象放疗前、放疗结束时及放疗结束后1月时外周血T淋巴细胞、CD4^+T细胞、调节性T细胞(Treg细胞)、自然杀伤细胞(NK细胞)、血小板与淋巴细胞比值(PLR)的变化情况。结果 54例直肠腺癌患者外周血T淋巴细胞绝对值、CD4^+T细胞绝对值、NK细胞绝对值、Treg细胞绝对值放疗结束时较放疗前下降,放疗结束后1月较放疗结束时升高,并差异有统计学意义(P<0.05)。PLR放疗结束时较放疗前、放疗结束后1月较放疗前升高,并差异有统计学意义(P<0.05),放疗结束后1月较放疗结束时下降,并差异有统计学意义(P<0.05)。结论局部进展期直肠癌患者经过放射治疗后外周血T淋巴细胞、CD4^+T细胞、NK细胞以及Treg细胞于放疗期间一过性下降,放疗结束后开始增高;PLR经放射治疗后明显升高,放疗结束后1月时较放疗结束时会有一定程度的下降。Objective To compare the immune functional indexes in peripheral blood of patients with locally advanced rectal cancer before,at the end of and one month after radiotherapy and analyze their clinical significance.Methods We selected 54 patients with locally advanced rectal cancer who received radiotherapy in Anhui provincial hospital from January 2018 to October 2019.The changes of T lymphocytes,CD4^+ T cells,Treg cells,NK cells in peripheral blood and platelet-lymphocyte-ratio(PLR) were detected before,at the end of and one month after radiotherapy.Results The absolute values of T lymphocytes,CD4^+ T cells,NK cells and Treg cells in the peripheral blood of 54 patients with rectal adenocarcinoma decreased at the end of radiotherapy compared with that before radiotherapy,and increased one month after radiotherapy compared with that at the end of radiotherapy,which showed statistically significant differences(P<0.05).The PLR increased after radiotherapy and the increase was observed to continue till one month after radiotherapy,which showed statistically significant differences(P<0.05).The index of PLR one month after radiotherapy was lower than that at the end of radiotherapy,which showed statistically significant differences(P<0.05).Conclusion The levels of T lymphocytes,CD4^+ T cells,NK cells and Treg cells in peripheral blood of patients with locally advanced rectal cancer decreased temporarily during radiotherapy,but gradually recovered after radiotherapy.The level of PLR increased at the end of radiotherapy and decreased one month after radiotherapy.

关 键 词：直肠肿瘤 放射疗法 T淋巴细胞 调节性 免疫系统现象 

分 类 号：R735.37[医药卫生—肿瘤]