放疗对局部晚期头颈部鳞状细胞癌患者免疫功能指标及肿瘤标志物的影响  

Effect of radiotherapy on immune function index and tumor marker in locally advanced head and neck squamous cell carcinoma patients

作　　者：张凯 刘培培 饶石磊[1] 王琦 华松 齐书然 杨峥[1] 王旸[1] ZHANG Kai;LIU Peipei;RAO Shilei;WANG Qi;HUA Song;QI Shuran;YANG Zheng;WANG Yang(Department of Radiotherapy,Nanyang Central Hospital,Nanyang 473000,He’nan,China;Department of Respiratory Medicine,Nanyang Central Hospital,Nanyang 473000,He’nan,China)

机构地区：[1]南阳市中心医院放疗科,河南南阳4730000 [2]南阳市中心医院呼吸科,河南南阳4730000

出　　处：《癌症进展》2022年第21期2241-2244,共4页Oncology Progress

摘　　要：目的探讨放疗对局部晚期头颈部鳞状细胞癌(HNSCC)患者免疫功能指标及肿瘤标志物的影响。方法将92例局部晚期HNSCC患者根据治疗方法不同分为化疗组(46例,采取单纯化疗)和联合组(46例,采取放疗联合化疗)。对比两组患者临床治疗效果、血清免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及肿瘤标志物[胸苷激酶1(TK1)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)和鳞状细胞癌相关抗原(SCC-Ag)]水平、生存情况。结果联合组患者客观缓解率(ORR)高于化疗组,差异有统计学意义(P﹤0.05)。治疗后,两组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均较治疗前降低,CD8^(+)水平均较治疗前升高,且联合组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均低于化疗组,CD8^(+)水平高于化疗组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者TK1、CYFRA21-1及SCC-Ag水平均低于治疗前,且联合组患者TK1、CYFRA21-1及SCC-Ag水平均低于化疗组,差异均有统计学意义(P﹤0.05)。联合组患者口腔黏膜炎发生率明显高于化疗组,差异有统计学意义(P﹤0.01)。联合组患者的总生存率为78.26%,高于化疗组患者的52.17%,差异有统计学意义(P﹤0.05)。结论放疗对局部晚期HNSCC有一定的疗效,可延长患者生存期,降低血清中TK1、CYFRA21-1及SCC-Ag等肿瘤标志物水平,且不良反应可耐受。Objective To investigate the effect of radiotherapy on immune function index and tumor marker in patients with locally advanced head and neck squamous cell carcinoma(HNSCC).Method A total of 92 patients with locally advanced HNSCC were divided into chemotherapy group(46 cases,chemotherapy alone)and combination group(46 cases,radiotherapy combined with chemotherapy)according to different treatment methods.The clinical treatment effect,serum immune function indexes(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),tumor markers[thymidine kinase 1(TK1),cytokeratin 19 fragment antigen 21-1(CYFRA21-1)and squamous cancinoma-associated antigen(SCC-Ag)]levels,and survival were compared between the two groups.Result The objective response rate(ORR)in the combination group was higher than that in the chemotherapy group,and the difference was statistically significant(P<0.05).After the treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the two groups were lower than those before the treatment,and the levels of CD8^(+)were higher than those before the treatment,and the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the combination group were lower than those in the chemotherapy group,while the level of CD8^(+)was higher than that in the chemotherapy group,and the differences were statistically significant(P<0.05).After the treatment,the levels of TK1,CYFRA21-1,and SCC-Ag in the two groups were lower than those before the treatment,and the levels in the combination group were lower than those in the chemotherapy group,and the differences were statistically significant(P<0.05).The incidence of oral mucositis in the combination group was significantly higher than that in the chemotherapy group,and the difference was statistically significant(P<0.01).The overall survival of patients in the combination group was 78.26%,which was higher than that in the chemotherapy group(52.17%),and the difference was statistically significant(P<0.05).Conclusion Radiotherapy has a certain effect on locally advanced HNSCC,prolongs the survival

关 键 词：放疗 头颈部鳞状细胞癌 免疫功能指标 肿瘤标志物 

分 类 号：R739.91[医药卫生—肿瘤]