术前区域动脉灌注化疗联合腹腔镜手术治疗结直肠癌患者血清肿瘤标志物、Treg细胞的变化及临床疗效  

Changes of serum tumor markers and Treg cells in patients with colorectal cancer treated with preoperative regional arterial infusion chemotherapy combined with laparoscopy and their clinical efficacy

作　　者：王进峰[1] 彭雷 付豹[1] 陈小贺[1] WANG Jinfeng;PENG Lei;FU Bao;CHEN Xiaohe(Department of Surgery,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China;不详)

机构地区：[1]石家庄市中医院外科,石家庄050000 [2]石家庄市藁城区人民医院外科

出　　处：《山东医药》2022年第28期16-19,共4页Shandong Medical Journal

基　　金：河北省医学科学研究重点课题(20181087)。

摘　　要：目的探讨术前区域动脉灌注化疗(PRAC)联合腹腔镜手术治疗结直肠癌患者血清肿瘤标志物、Treg细胞变化及其临床疗效。方法选取164例结直肠癌患者按照治疗方案不同分成对照组81例、观察组83例,两组性别、年龄、肿瘤部位、肿瘤直径、组织类型、分化程度等基础资料比较差异无统计学意义。对照组仅行腹腔镜手术治疗;观察组先行PRAC,化疗结束后7 d再行腹腔镜手术治疗。术后两组均接受4个周期的FOLFOX全身静脉化疗。入组时、术后4个化疗周期采用电化学发光法检测血清癌胚抗原(CEA)、糖类抗原199(CA199)、CA724等肿瘤标志物,采用流式细胞仪检测Treg细胞(CD4^(+)CD25^(+)Treg、CD4^(+)CD25^(+)FoxP3^(+)Treg)。出院后定期随访,评价两组近期及远期疗效。结果观察组术中出血量少于对照组(P<0.05),手术用时、术后排气时间、术后住院时间与对照组比较差异无统计学意义(P均>0.05)。术后4个化疗周期两组血清CEA、CA199、CA724水平及Treg细胞表达较入组时降低(P均<0.05),且观察组均低于对照组(P均<0.05)。观察组近期有效率为80.72%,3年及5年生存率分别为61.45%、44.58%;对照组近期有效率为55.56%,3年及5年生存率分别为41.98%、25.93%。观察组近期、远期疗效均优于对照组(P均<0.05)。结论PRAC联合腹腔镜手术治疗可降低结直肠癌患者血清肿瘤标志物、Treg细胞表达,提高近远期疗效。Objective To investigate the changes of serum tumor markers and Treg cells in patients with colorectal cancer treated with preoperative regional arterial infusion chemotherapy(PRAC)combined with laparoscopy and their clinical efficacy.Methods A total of 164 colorectal cancer patients were selected and were divided into the control group of 81 cases and observation group of 83 cases according to different treatment plans.There were no significant differences in the basic data such as gender,age,tumor location,tumor diameter,tissue type,or degree of differentiation between the two groups.The patients in the control group only received laparoscopic surgery;the patients in the observation group received PRAC first,and then underwent laparoscopic surgery at 7 days after chemotherapy;patients in both groups received 4 cycles of FOLFOX systemic intravenous chemotherapy after surgery.At the time of enrollment and 4 chemotherapy cycles after operation,electrochemiluminescence was used to detect serum carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),CA724 and other tumor markers,and flow cytometry was used to detect Treg cells(CD4^(+)CD25^(+)Treg,CD4^(+)CD25^(+)FoxP3^(+)Treg).Regular follow-up after discharge was performed to evaluate the short-term and long-term efficacy of the two groups.Results The amount of intraoperative blood loss in the observation group was less than that in the control group(P<0.05),and there was no significant difference in operation time,postoperative exhaust time,and postoperative hospitalization time between the observation group and the control group(all P>0.05).After 4 chemotherapy cycles,the serum levels of CEA,CA199,CA724 and the expression of Treg cells in the two groups were lower than those at the time of entry(all P<0.05),and the observation group was lower than the control group(all P<0.05).The short-term effective rate of the observation group was 80.72%,the 3-year and 5-year survival rates were 61.45%and 44.58%,respectively;the short-term effective rate of the control g

关 键 词：结直肠肿瘤 动脉灌注化疗 腹腔镜手术 血清肿瘤标志物 TREG细胞 

分 类 号：R735.3[医药卫生—肿瘤]