中低位进展期直肠癌患者外周血T淋巴细胞亚群水平变化对新辅助同步放化疗效果的影响  

Effects of changes in peripheral blood T lymphocyte subsets levels in patients with middle and low advanced rectal cancer on the effect of neoadjuvant concurrent radiotherapy and chemotherapy.

作　　者：糜英华[1] 高登鹏[1] 李荣[1] 王相[1] 张霄程[1] 龚雪鹏 MI Ying-hua;GAO Deng-peng;LI Rong(Department of General Surgery,Langfang People's Hospital,Langfang Hebei 065000,China.)

机构地区：[1]河北省廊坊市人民医院普外科,河北廊坊065000 [2]空军第986医院医学影像科MR室,陕西西安710054

出　　处：《临床和实验医学杂志》2021年第17期1850-1853,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省医学适用技术跟踪项目(编号:2016001546);廊坊市科学技术研究与发展计划(编号:2015013046)。

摘　　要：目的探讨中低位进展期直肠癌患者外周血T淋巴细胞亚群水平变化对新辅助同步放化疗效果的影响。方法回顾性选择2018年1月至2020年1月廊坊市人民医院收治的中低位进展期直肠癌患者102例,依据治疗方法不同分为观察组51例与对照组51例。2组患者均由同一组医师完成。对照组患者依据全直肠系膜切除术原则实施根治切除术,术前各项检查明确无手术禁忌证,确定手术方案;观察组患者在新辅助放化疗结束后1周行根治切除术治疗。2组患者疗程均为5周。比较2组患者R0切除率和保肛率,生存质量改善情况;治疗前后外周血T淋巴细胞亚群水平变化;及随访12个月复发情况。结果2组患者R0切除率比较(96.08%vs 94.12%),差异无统计学意义(P>0.05);观察组患者保肛率(90.20%)高于对照组(74.51%),差异有统计学意义(P<0.05)。观察组患者生存质量提高率(82.35%)高于对照组(64.71%),差异有统计学意义(P<0.05)。对照组患者治疗后CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)与治疗前比较,差异均无统计学意义(P>0.05);观察组患者治疗后CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)低于治疗前,差异均有统计学意义(P<0.05);且观察组患者治疗后CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)为(51.49±3.25)%、(30.57±2.76)%、1.68±0.17,低于对照组[(56.16±4.89)%、(36.08±2.98)%、1.37±0.21],差异均有统计学意义(P<0.05)。观察组患者随访12个月复发率(1.96%)低于对照组(15.69%),差异有统计学意义(P<0.05)。结论中低位进展期直肠癌患者采用新辅助同步放化疗患者疗效良好,且可改善患者生存质量,降低患者复发和转移,但会导致患者免疫功能下降。Objective To investigate the effect of changes in peripheral blood T lymphocyte subsets levels in patients with middle and low advanced rectal cancer on the effect of neoadjuvant concurrent radiotherapy and chemotherapy.Methods A total of 102 patients with advanced rectal cancer in Langfang People's Hospital from January 2018 to January 2020 were retrospectively selected,and divided into the observation group and control group according to different methods,each group 51 cases.Both groups of patients were completed by the same group of physicians.Patients in the control group underwent radical resection based on the principle of total mesorectal resection.The preoperative examinations confirmed that there were no contraindications to the operation,and the surgical plan was determined;patients in the observation group underwent radical resection one week after the end of neoadjuvant radiotherapy and chemotherapy.The course of treatment for both groups was 5 weeks.Comparison of R0 resection rate and anus preservation rate,quality of life improvement of the two groups of patients;changes in peripheral blood T lymphocyte subsets levels before and after treatment;and 12-month follow-up for recurrence and metastasis.Results There was no significant difference in the R0 resection rate between the two groups(96.08%vs 94.12%,P>0.05);the anus preservation rate of the observation group(90.20%)was higher than that of the control group(74.51%),the difference was statistically significant(P<0.05).The improvement rate of the quality of life of patients in the observation group(82.35%)was higher than that in the control group(64.71%),the difference was statistically significant(P<0.05).There was no statistically significant difference in CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)after treatment in the control group compared with before treatment(P>0.05).The CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05);and CD3^(

关 键 词：中低位进展期直肠癌 T淋巴细胞亚群 新辅助同步放化疗 

分 类 号：R735.37[医药卫生—肿瘤]