多西紫杉醇联合卡铂术前新辅助化疗对局部晚期宫颈癌患者近期疗效及外周血T淋巴细胞亚群的影响  

Effect of docetaxel combined with carboplatin preoperative neoadjuvant chemotherapy on short-term efficacy and peripheral blood T lymphocyte subsets in patients with locally advanced cervical cancer

作　　者：李文娟 郭雪 程新 秦爽 尚宪平 LI Wenjuan;GUO Xue;CHENG Xin;QIN Shuang;SHANG Xianping(Department of Clinical Laboratory,Jinan People's Hospital Affiliated to Shandong First Medical University,Shandong Jinan 271199,China;Department of Health Care,Jinan People's Hospital Affiliated to Shandong First Medical University,Shandong Jinan 271199,China;Department of Gynecology,Jinan People's Hospital Affiliated to Shandong First Medical University,Shandong Jinan 271199,China.)

机构地区：[1]山东第一医科大学附属济南人民医院检验科,山东济南271199 [2]山东第一医科大学附属济南人民医院干部保健科,山东济南271199 [3]山东第一医科大学附属济南人民医院妇科,山东济南271199

出　　处：《现代肿瘤医学》2024年第15期2851-2856,共6页Journal of Modern Oncology

基　　金：山东省医药卫生科技发展计划项目(编号:202105010536)。

摘　　要：目的:探讨分析多西紫杉醇联合卡铂术前新辅助化疗对局部晚期宫颈癌患者近期疗效及外周血T淋巴细胞亚群的影响。方法:选择2019年03月至2021年03月该院收治的局部宫颈癌患者104例,将其随机分为A组53例、B组51例。其中A组患者给予多西紫杉醇^(+)卡铂治疗,B组患者给予氟尿嘧啶^(+)卡铂治疗。比较两组患者化疗近期疗效、化疗前后外周血T淋巴细胞亚群变化、化疗严重不良反应、手术相关指标。结果:A组患者化疗近期总有效率为71.70%,B组化疗近期总有效率为60.78%;A组化疗临床获益率为90.57%,B组化疗临床获益率为88.24%。两组化疗近期总有效率及化疗临床获益率比较差异无统计学意义(P>0.05)。化疗前两组患者CD3^(+)、CD4^(+)、CD8^(+)以及CD4^(+)/CD8^(+)水平比较,差异均无统计学意义(P>0.05);化疗后两组患者CD3^(+)、CD4^(+)以及CD4^(+)/CD8^(+)水平较化疗前显著降低(P<0.05),B组患者化疗后CD8^(+)水平较化疗前显著升高(P<0.05);化疗后A组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平显著高于B组(P<0.05),化疗后A组患者CD8^(+)水平显著低于B组(P<0.05)。A组严重不良反应发生率显著低于B组(P<0.05)。两组患者手术时间、术中出血量、盆腔淋巴结转移率以及阴道切缘阳性率比较,差异均无统计学意义(P>0.05)。结论:多西紫杉醇联合卡铂新辅助化疗对局部晚期宫颈癌患者近期疗效与氟尿嘧啶联合卡铂方案相似,但多西紫杉醇方案对患者免疫功能的影响较小,且化疗严重不良反应发生率较低,值得临床推广。Objective:To explore and analyze the effects of docetaxel combined with carboplatin preoperative neoadjuvant chemotherapy on the short-term efficacy and peripheral blood T lymphocyte subsets in patients with locally advanced cervical cancer.Methods:104 patients with local cervical cancer admitted to our hospital from March 2019 to March 2021 were randomly divided into group A(53 cases)and group B(51 cases).Patients in group A were treated with docetaxel^(+)carboplatin,and patients in group B were treated with fluorouracil^(+)carboplatin.The short-term efficacy of chemotherapy,the changes of peripheral blood T lymphocyte subsets before and after chemotherapy,serious adverse reactions of chemotherapy,and surgery-related indicators were compared between the two groups.Results:The short-term total effective rate was 71.70%in group A and 60.78%in group B.The clinical benefit rate of group A and group B was 90.57%and 88.24%respectively.There was no significant difference in the short-term total response rate and clinical benefit rate of chemotherapy between the two groups(P>0.05).There were no significant differences in the levels of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)between two groups before chemotherapy(P>0.05).After chemotherapy,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in two groups were significantly decreased compared with before chemotherapy(P<0.05),and the level of CD8^(+)in group B was significantly increased compared with before chemotherapy(P<0.05).After chemotherapy,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in group A were significantly higher than those in group B(P<0.05),and the levels of CD8^(+)in group A were significantly lower than those in group B(P<0.05).The incidence of serious adverse reactions in group A was significantly lower than that in group B(P<0.05).There were no significant differences in operation time,intraoperative blood loss,pelvic lymph node metastasis rate and positive rate of vaginal incision margin between two groups(P>0.05).Conclusion:The short-term efficacy o

关 键 词：多西紫杉醇 卡铂 新辅助化疗 局部晚期 宫颈癌 疗效 T淋巴细胞 

分 类 号：R737.33[医药卫生—肿瘤]