腹腔热灌注化疗联合静脉化疗、腹腔镜手术治疗卵巢癌患者的疗效及对炎症微循环的影响  

Efficacy of intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy and laparoscopic surgery in ovarian cancer patients and its effect on inflammatory microcirculation

作　　者：高争 孟宪华 吕昌玉 赵颖辉 尚宪平 刘晓霞 杨逢永 王晓红 GAO Zheng;MENG Xianhua;LYU Changyu;ZHAO Yinghui;SHANG Xianping;LIU Xiaoxia;YANG Fengyong;WANG Xiaohong(Department of Gynecology,Ji'nan People's Hospital,Ji'nan 271100,Shandong,China;Department of Emergency,Ji'nan People's Hospital,Ji'nan 271100,Shandong,China)

机构地区：[1]济南市人民医院妇科,济南271100 [2]济南市人民医院急诊科,济南271100

出　　处：《癌症进展》2024年第21期2329-2333,共5页Oncology Progress

基　　金：山东省自然科学基金(ZR2021MH329);济南市科学技术局临床医学科技创新计划项目(202134055、202225067)。

摘　　要：目的 探讨腹腔热灌注化疗联合静脉化疗、腹腔镜手术治疗卵巢癌患者的疗效及对炎症微循环的影响。方法 将170例卵巢癌患者根据治疗方法的不同分为常规组(n=85,接受静脉化疗联合腹腔镜手术)与联合组(n=85,接受腹腔热灌注化疗联合静脉化疗、腹腔镜手术)。比较两组患者的临床疗效、血管内皮生长因子(VEGF)水平、T淋巴细胞亚群水平、生活质量[卡氏功能状态(KPS)评分]及不良反应发生情况。结果 联合组患者总有效率明显高于常规组,差异有统计学意义(P﹤0.01)。治疗后,联合组患者VEGFA、VEGFB、VEGFC水平均明显低于常规组,CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均明显高于常规组,差异均有统计学意义(P﹤0.01)。治疗后,联合组患者KPS评分明显高于常规组,差异有统计学意义(P﹤0.01)。两组患者腹痛、恶心呕吐、骨髓抑制、肾功能损伤发生率比较,差异均无统计学意义(P﹥0.05)。结论 腹腔热灌注化疗联合静脉化疗、腹腔镜手术治疗卵巢癌患者的疗效显著,可降低VEGF水平,调节T淋巴细胞亚群水平,提高患者生活质量。Objective To investigate the efficacy of intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy and laparoscopic surgery in ovarian cancer patients and its effect on inflammatory microcirculation.Method A total of 170 patients with ovarian cancer were divided into conventional group(n=85,received intravenous chemotherapy combined with laparoscopic surgery)and combined group(n=85,received intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy and laparoscopic surgery)according to different treatment methods.The clinical efficacy,vascular endothelial growth factor(VEGF)level,T lymphocyte subsets levels,quality of life[Karnofsky performance status(KPS)score]and the incidences of adverse reactions were compared between the two groups.Result The total effective rate of the combined group was higher than that of the conventional group,the difference was statistically significant(P<0.01).After treatment,the levels of VEGFA,VEGFB and VEGFC in combined group were significantly lower than those in conventional group,while the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were significantly higher than those in conventional group,the differences were statistically significant(P<0.01).After treatment,the KPS score in combined group was significantly higher than that in conventional group,and the difference was statistically significant(P<0.01).There were no significant differences in the incidences of abdominal pain,nausea and vomiting,bone marrow suppression and renal function injury between the two groups(P>0.05).Conclusion Intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy and laparoscopic surgery is effective in the treatment of ovarian cancer patients,which can reduce VEGF level,regulate T lymphocyte subsets,and improve the quality of life.

关 键 词：卵巢癌 腹腔热灌注化疗 静脉化疗 腹腔镜手术 炎症微循环 

分 类 号：R737.31[医药卫生—肿瘤]