循环腹腔热灌注化疗治疗恶性腹腔积液的疗效及预后影响因素  

Efficacy and prognostic factors of Continous Hyperthermic Peritoneal Perfusion Chemotherapy in the treatment of malignant ascites

作　　者：汪曙红[1] 王根和[1] 钱六七[1] 胡捷 陈雍[1] 胡善良 WANG Shuhong;WANG Genhe;QIAN Liuqi;HU Jie;CHEN Yong;HU Shanliang(Department of Oncology,Huangshan People's Hospital,Huangshan245000,China)

机构地区：[1]黄山市人民医院肿瘤科,安徽黄山245000

出　　处：《中国肿瘤外科杂志》2024年第4期388-392,共5页Chinese Journal of Surgical Oncology

基　　金：安徽省黄山市人民医院新技术、新项目(20230831⁃01)。

摘　　要：目的探究消化道肿瘤伴恶性腹腔积液患者接受循环腹腔热灌注化疗(CHPPC)治疗的疗效及预后因素。方法选取2019年1月至2022年1月黄山市人民医院收治的190例消化道肿瘤伴恶性腹腔积液患者为研究对象。根据治疗方法不同分为试验组和对照组,试验组采用循环腹腔热灌注化疗(CHPPC),对照组采用常规腹腔灌注化疗,各95例。均进行2个疗程的治疗。观察两组的治疗疗效,对比两组的免疫功能。根据试验组患者治疗后复发及转移情况,分为有效组(67例)和无效组(28例),并进行预后因素分析。结果试验组总有效率高于对照组(P<0.05)。治疗后,两组患者的CD4^(+)均升高,CD8^(+)均降低,与对照组相比,试验组的CD4^(+)升高,CD8^(+)降低变化,差异有统计学意义(P<0.05)。单因素分析显示,无效组在年龄、肿瘤原发部位、腹腔积液量、卡氏功能状态(KPS)评分、癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原125(CA125)等方面与有效组比较有差异(P<0.05)。Cox回归分析结果显示,肿瘤原发部位、KPS评分、腹腔积液量、CEA、CA199、CA125是消化道肿瘤伴恶性腹腔积液患者预后的独立影响因素(P<0.05)。结论CHPPC对消化道肿瘤伴恶性腹腔积液患者具有一定疗效,可改善其免疫功能,肿瘤原发部位、KPS评分、腹腔积液量、CEA、CA199、CA125等与消化道肿瘤伴恶性腹腔积液患者预后有关。Objective To investigate the therapeutic effect and prognostic factors of patients with gastrointestinal tumors accompanied by malignant ascites receiving continuous hyperthermic peritoneal perfusion chemotherapy(CHPPC).Methods A total of 190 patients with gastrointestinal tumors accompanied by malignant ascites admitted to Huangshan Peoples Hospital from January 2019 to January 2022 were selected as study objects.According to different treatment methods,the patients were divided into an experimental group and a control group,95 cases each.The experimental group was treated with CHPPC,while the control group was treated with routine intraperitoneal perfusion chemotherapy for 2 courses.The therapeutic effect of the two groups was observed,and the immune function of the two groups were compared.According to the recurrence and metastasis after treatment,the experimental group was divided into an effective group(67 cases)and an ineffective group(28 cases),and prognostic factors were analyzed.Results The total effective rate of the experimental group was higher than that of the control group(P<0.05).After treatment,CD4^(+)increased and CD8^(+)decreased in both groups,and the changes in the experimental group were more significant than those in the control group(P<0.05).Univariate analysis showed that there were statistically significant differences between the effective group and the ineffective group in age,primary tumor site,abdominal fluid volume,KPS score,CEA,CA199,CA125 and other aspects(P<0.05).Cox regression analysis showed that the primary site of tumor,KPS score,volume of peritoneal fluid,CEA,CA199,CA125 were independent prognostic factors for patients with gastrointestinal tumor and malignant peritoneal fluid(P<0.05).Conclusions CHPPC has a certain effect on patients with gastrointestinal tumors accompanied by malignant ascites,and can improve patientsimmune function.The primary site of tumor,KPS score,amount of abdominal effusion,CEA,CA199,CA125,etc.are related to the prognosis of patients with gastrointest

关 键 词：消化道肿瘤 恶性腹腔积液 循环腹腔热灌注化疗 疗效 预后 

分 类 号：R735[医药卫生—肿瘤]