支气管动脉化疗栓塞联合放射性I125粒子局部植入治疗对中晚期肺鳞癌肿瘤标志物和T细胞亚群的影响评价研究  

Evaluation of the Effect of Bronchial Artery Chemoembolization Combined with Local Implantation of Radioactive I125 Seeds on Tumor Markers and T Cell Subsets in Advanced Lung Squamous Cell Carcinoma

作　　者：贺赟贤 赵年贵 李可聪 HE Yun-xian;ZHAO Nian-gui;LI Ke-cong(Department of Respiratory Medicine,the Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian Province,361100 China)

机构地区：[1]厦门医学院附属第二医院呼吸内科,福建厦门361100

出　　处：《中外医疗》2020年第29期15-19,共5页China & Foreign Medical Treatment

摘　　要：目的讨论支气管动脉化疗栓塞联合放射性I125粒子局部植入治疗对于中晚期肺鳞癌肿瘤标志物以及T细胞亚群的影响。方法回顾分析2016年1月—2019年12月78例中晚期肺鳞癌患者,其中接受支气管动脉化疗栓塞治疗为对照组,接受支气管动脉化疗栓塞治疗联合放射性粒子局部植入治疗为观察组,对比两组疗效及治疗前后肿瘤标志物和T细胞亚群的变化。结果治疗有效中,观察组效果优于对照组,差异有统计学意义(χ2=5.571,P<0.05);治疗有效中,观察组治疗后CYFRA21-1(3.05±0.96)ng/mL,CEA(5.94±1.57)ng/mL,SCC(1.36±0.19)ng/mL,两组肿瘤标志物CYFRA21-1、CEA、SCC较治疗前均明显下降,差异有统计学意义(t=12.367、8.646、8.310,P<0.05);治疗无效中,肿瘤标志物CYFRA21-1、CEA、SCC较治疗前均明显升高,两组之间差异无统计学意义(t=0.028、0.049、0.073,P>0.05)。治疗有效中,观察组治疗后NK细胞(16.28±2.46)%,CD4+(39.84±4.80)%,CD8+(31.42±3.61)%,CD4+/CD8+(1.26±0.41)%,观察组治疗后两组T细胞亚群水平较前治疗前均出现明显改善(P<0.05):观察组T细胞亚群水平好于对照组(t=4.966、4.651、4.352、4.285,P<0.001)。治疗无效中,治疗后两组T细胞亚群水平均好于治疗前,但仍未达到正常水平,两组之间差异无统计学意义(t=0.164、0.563、0.000、0.000,P>0.05)。结论对中晚期肺鳞癌给予支气管动脉化疗栓塞联合放射性粒子局部植入治疗效果优于单独接受支气管动脉化疗栓塞治疗,联合治疗可有效发挥出两种治疗方法的优势,进一步降低肿瘤标志物的水平,并提高T细胞水平,缓解肿瘤恶化速度,提高临床疗效,可推广应用。肿瘤标志物和T亚群细胞水平可作为临床疗效判断指标。Objective To discuss the effects of bronchial arterial chemoembolization combined with local implantation of radioactive I125 seeds on tumor markers and T cell subsets in advanced lung squamous cell carcinoma.Methods A retrospective analysis of 78 patients with advanced lung squamous cell carcinoma from January 2016 to December 2019,of which received bronchial artery chemoembolization treatment as the control group,and received bronchial artery chemoembolization treatment combined with radioactive seed local implantation as the observation group.The efficacy of the two groups and the changes of tumor markers and T cell subsets before and after treatment were compared.Results The treatment was effective,the observation group was better than the control group,the difference was statistically significant(χ2=5.571,P<0.05);the treatment was effective,the observation group CYFRA21-1(3.05±0.96)ng/mL,CEA(5.94±1.57)ng/mL,SCC(1.36±0.19)ng/mL after treatment,the tumor markers CYFRA21-1,CEA,and SCC of the two groups were significantly decreased compared with before treatment,the difference between the two groups was statistically significant(t=12.367,8.646,8.310,P<0.05);in the treatment failure,the tumor markers CYFRA21-1,CEA,SCC were significantly higher than before treatment,there was no statistical significance difference between the two groups(t=0.028,0.049,0.073,P>0.05).The treatment was effective.After treatment in the observation group,NK cells(16.28±2.46)%,CD4+(39.84±4.80)%,CD8+(31.42±3.61)%,CD4+/CD8+(1.26±0.41)%,two groups of T cell subsets after treatment was significantly improved compared with that before the treatment(t=8.524,11.372,6.534,8.920,P<0.001):the level of T cell subsets in the observation group was better than that of the control group(P<0.05).In the treatment failure,the levels of T cell subsets in the two groups after treatment were better than those before treatment,but they still did not reach the normal level.There was no statistical significance between the two groups(t=0.164,0.563,0.000

关 键 词：中晚期肺鳞癌 支气管动脉化疗栓塞 放射性I125粒子局部植入 肿瘤标志物 T细胞亚群 

分 类 号：R5[医药卫生—内科学]