微波消融对晚期结直肠癌伴肺部寡转移患者免疫功能及预后的影响  

Effect of Microwave Ablation on Immune Function and Prognosis of Patients with Advanced Colorectal Cancer with Lung Metastasis

作　　者：胡钰丰 李道明[1] 李大鹏[1] 徐彩华[1] 陶敏[1] HU Yufeng;LI Daoming;LI Dapeng(First Affiliated Hospital of Suzhou University)

机构地区：[1]苏州大学附属第一医院肿瘤科,215008

出　　处：《长治医学院学报》2022年第1期27-30,39,共5页Journal of Changzhi Medical College

基　　金：国家自然科学基金(81772645);苏州市科技计划项目(SKJY2021072)。

摘　　要：目的:探讨肺微波消融(MWA)对晚期结直肠癌(CRC)伴肺部寡转移患者免疫功能及预后的影响。方法:纳入确诊为晚期CRC肺部寡转移患者47例,分为联合治疗组和单纯内科治疗组。单纯内科治疗组接受贝伐单抗/西妥昔单抗化疗,联合治疗组在内科治疗前接受肺部肿瘤MWA治疗。比较2组治疗前后免疫指标(CD3^(+),CD3^(+)/CD4^(+),CD3^(+)/CD8^(+),CD4^(+)/CD8^(+)),实体瘤疗效评价标准评价疗效及患者无进展生存期(PFS)的差异。结果:2组患者术前CD3^(+),CD3^(+)/CD4^(+),CD3^(+)/CD8^(+),CD4^(+)/CD8^(+)差异无统计学意义(P>0.05);治疗后14 d,联合治疗组患者CD3^(+)[(70.61±5.23)vs(62.93±4.09)],CD3^(+)/CD4^(+)[(41.29±4.05)vs(32.48±2.72)],CD3^(+)/CD8^(+)[(28.03±3.06)vs(26.32±1.89)],CD4^(+)/CD8^(+)[(1.49±0.20)vs(1.24±0.12)]显著高于单纯内科治疗组(P<0.05);联合治疗组客观有效率(ORR)(73.91%)显著高于单纯内科治疗组(33.33%),差异有统计学意义(P<0.05);联合治疗组中位PFS(15.5个月)显著长于单纯内科治疗组(10.0个月),差异有统计学意义(P<0.05)。结论:肺转移瘤MWA联合化疗可增强晚期结直肠癌患者机体免疫功能,延长患者的生存期。Objective:To investigate the effects of microwave ablation(MWA)on the immune function and prognosis in advanced colorectal cancer(CRC)patients with the lung metastasis.Methods:A total of 47 patients who were diagnosed with advanced CRC with lung metastasis.The patients were divided into combined treatment group and medical alone treatment group.The combined treatment group received MWA treatment of lung tumors before medical treatment.The medical alone treatment group were treated with bevacizumab/cetuximab^(+)chemotherapy.Peripheral blood of the two groups was collected 1 day before and 14 days after treatment.The ratio of CD3^(+),CD3^(+)/CD4^(+),CD3^(+)/CD8^(+),CD4^(+)/CD8^(+)cells in peripheral blood was compared.The curative effect was evaluated by solid tumor efficacy evaluation standard.The progression free survival(PFS)were compared between the two groups by survival analysis,showing no difference.Results:There were no significant differences in the ratio of CD3^(+),CD3^(+)/CD4^(+),CD3^(+)/CD8^(+),CD4^(+)/CD8^(+)cells between combined treatment group and medical alone treatment group(P>0.05).On the 14th day after operation,the ratio of CD3^(+)[(70.61±5.23)vs(62.93±4.09)],CD3^(+)/CD4^(+)[(41.29±4.05)vs(32.48±2.72)],CD3^(+)/CD8^(+)[(28.03±3.06)vs(26.32±1.89)],CD4^(+)/CD8^(+)[(1.49±0.20)vs(1.24±0.12)]cells of peripheral blood in combined treatment group were significantly higher than the preoperative level in the medical alone treatment group and the combined treatment group(P<0.05);The objective response rate(ORR)(73.91%),of the combined treatment group was significantly higher than that of the medical only group(33.33%);the differences were all statistically significant(P<0.05);The median PFS(15.5 months)of the combined treatment group was significantly higher than that of the medical alone treatment group(10.0 months),the differences were all statistically significant(P<0.05).Conclusion:MWA of lung metastasis with combined chemotherapy can effectively activate the immune function and enhance progno

关 键 词：微波消融 晚期结直肠癌 细胞免疫 

分 类 号：R735.3[医药卫生—肿瘤]