不同放疗方案联合手术治疗中低位局部进展期直肠癌的效果及对肿瘤标志物的影响  

Effectiveness of Different Radiotherapy Regimens Combined with Surgery in the Treatment of Medium to Low Locally Progressive Rectal Cancer and the Effect on Tumor Markers

作　　者：吴仁瑞[1] 钟琼[1] 黄蓉[1] WU Renrui;ZHONG Qiong;HUANG Rong(Ganzhou People's Hospital,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]江西省赣州市人民医院,江西赣州341000

出　　处：《中国医学创新》2023年第17期55-59,共5页Medical Innovation of China

摘　　要：目的:探讨不同放疗方案联合手术治疗中低位局部进展期直肠癌的效果及对肿瘤标志物的影响。方法:选取2019年1月-2020年1月于赣州市人民医院诊治的98例中低位局部进展期直肠癌患者,使用随机数字表法将其分为观察组及对照组,各49例。两组患者均接受腹腔镜直肠癌根治术治疗,对照组术前行新辅助放化疗,观察组术前行全程新辅助治疗。对比两组的近远期疗效、并发症发生率、血清肿瘤标志物水平及免疫功能指标。结果:观察组的客观缓解率高于对照组(P<0.05),2年局部复发率及远处转移率均低于对照组(P<0.05)。两组的并发症发生率相比,差异无统计学意义(P>0.05)。治疗前,两组的血清组织多肽特异抗原(TPS)、细胞角蛋白19片段(CYFRA21-1)、脂肪酸合成酶(FAS)及肿瘤型M2丙酮酸激酶(TuM2-PK)水平相比,差异均无统计学意义(P>0.05);治疗后,两组的各项指标水平均降低,观察组均低于对照组(P<0.05)。治疗前,两组的CD3^(+)、CD4^(+)及CD8^(+)水平相比,差异均无统计学意义(P>0.05);治疗后,两组的CD3^(+)、CD4^(+)水平均下降,但观察组均高于对照组(P<0.05),CD8^(+)均上升,但观察组低于对照组(P<0.05)。结论:腹腔镜直肠癌根治术前全程新辅助治疗中低位局部进展期直肠癌近远期效果显著,未增加并发症,同时可显著降低血清肿瘤标志物水平,对免疫功能的损伤程度较低。Objective:To investigate the effect of intensity-modulated radiotherapy combined with surgery for medium to low locally progressive rectal cancer and the effect on tumor markers.Method:Ninety-eight patients with medium to low locally progressive rectal cancer treated in Ganzhou People's Hospital from January 2019 to January 2020 were selected and divided into observation group and control group using the random number table method,with 49 cases each.Both groups received laparoscopic radical rectal cancer treatment,and the control group was treated with neoadjuvant radiotherapy before surgery,while the observation group was treated with full neoadjuvant therapy before surgery.The near and long-term efficacy,complication rate,serum tumor marker levels and immune function indexes of the two groups were compared.Result:The objective remission rate of the observation group was higher than that of the control group(P<0.05),and the 2-year local recurrence rate and distant metastasis rate were lower than those of the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Before treatment,the levels of serum tissue polypeptide specific antigen(TPS),cytokeratin 19 fragment(CYFRA21-1),fatty acid synthase(FAS)and tumortype M2 pyruvate kinase(TuM2-PK)were not significantly different between the two groups(P>0.05);after treatment,the levels of each index were reduced in both groups,and the observation group were lower than those of the control group(P<0.05).Before treatment,the levels of CD3^(+),CD4^(+)and CD8^(+)in the two groups were not significantly different compared(P>0.05);after treatment,the levels of CD3^(+)and CD4^(+)decreased in both groups,but the observation group were higher than those of the control group(P<0.05),and CD8^(+)increased in both groups,but the observation group was lower than that of the control group(P<0.05).Conclusion:Full neoadjuvant treatment for middle to low locally progressive rectal cancer before laparoscopic radical resecti

关 键 词：中低位局部进展期直肠癌 全程新辅助治疗 肿瘤标志物 免疫功能 

分 类 号：R735.37[医药卫生—肿瘤]