微创手术联合术后腹腔热灌注化疗对进展期食管胃交界部腺癌患者细胞免疫因子及肿瘤标志物的影响  

Impact of minimally invasive surgery combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy on cellular immune factors and tumor markers in patients with advanced adenocarcinoma of the esophagogastric junction

作　　者：杨龙龙[1] 尹清臣[1] 李忠信 巩文婷[1] 刘国魁[1] 温桂海[1] 牛学敏[1] 张肖[2] Long-long Yang;Qing-chen Yin;Zhong-xin Li;Wen-ting Gong;Guo-kui Liu;Gui-hai Wen;Xue-min Niu;Xiao Zhang(Department of General Surgery,Handan Central Hospital,Handan,Hebei 056001,China;Department of Infectious Diseases,Handan Central Hospital,Handan,Hebei 056001,China)

机构地区：[1]邯郸市中心医院普外一科,河北邯郸056001 [2]邯郸市中心医院感染性疾病科,河北邯郸056001

出　　处：《中国内镜杂志》2020年第6期14-19,共6页China Journal of Endoscopy

基　　金：河北省重点研发计划自筹项目(No:182777241)。

摘　　要：目的探讨微创手术联合术后腹腔热灌注化疗对进展期食管胃交界部腺癌(AEGJ)患者细胞免疫因子及甲胎蛋白(AFP)、糖类抗原724(CA724)和癌胚抗原(CEA)的影响。方法选取2014年1月-2016年1月该院进展期AEGJ患者200例,依据随机数字表分为A组和B组,每组100例,A组给予微创手术常规治疗,B组在此基础上联合术后腹腔热灌注化疗治疗,比较两组细胞免疫因子(T淋巴细胞亚群CD3^+、CD4^+、CD4^+/CD25^+)、肿瘤标志物(AFP、CA724、CEA)、不良反应和生存情况。结果A组和B组治疗后CD3^+、CD4^+明显高于治疗前,B组治疗后CD3^+、CD4^+明显高于A组,A组和B组治疗后CD4^+/CD25^+、AFP、CA724和CEA明显低于治疗前,B组治疗后CD4^+/CD25^+、AFP、CA724和CEA明显低于A组,差异均有统计学意义(P<0.05);B组3年生存率明显高于A组,差异有统计学意义(P<0.05);A组和B组不良反应发生率比较,差异无统计学意义(P>0.05)。结论微创手术联合术后腹腔热灌注化疗,可增强进展期AEGJ患者细胞免疫能力,改善AFP、CA724和CEA水平,提高生存率,且安全性好。Objective To discuss the impact of minimally invasive surgery combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy on cellular immunity,alpha-fetoprotein(AFP),carbohydrate antigen 724(CA724)and carcinoembryonic antigen(CEA)in patients with advanced adenocarcinoma of the esophagogastric junction(AEGJ).Methods 200 patients with AEGJ from January 2014 to January 2016 were selected,they were divided into group A and group B according to random number table.The group A was received routine treatment of minimally invasive surgery,the group B was received postoperative intraperitoneal hyperthermic perfusion chemotherapy on the basis.The cellular immunity(T lymphocyte subsets CD3^+,CD4^+/CD25^+),tumor markers(AFP,CA724,CEA),adverse reactions and survival situation were compared between the two groups.Results The CD3^+,CD4^+in group A and group B after treatment were significantly higher than those before treatment,the CD3^+,CD4^+in group B after treatment were significantly higher than those in group A,the CD4^+/CD25^+,AFP,CA724 and CEA in group A and group B after treatment were significantly lower than those before treatment,the CD4^+/CD25^+,AFP,CA724 and CEA in group B after treatment were significantly lower than those in group A,the difference was statistically significant(P<0.05).The 3-year survival rate in group B was significantly higher than that in group A,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Minimally invasive surgery combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy can effectively improve the cellular immunity and the AFP,CA724 and CEA levels in patients with AEGJ,which can improve the survival and prognosis of patients,it has the good safety.

关 键 词：进展期食管胃交界部腺癌 微创手术 腹腔热灌注化疗 细胞免疫 甲胎蛋白 糖类抗原724 癌胚抗原 

分 类 号：R735[医药卫生—肿瘤]