胃癌动静脉结合的术前化疗对病人T淋巴细胞亚群的影响

发布时间：2018-06-11 12:17

  本文选题：免疫抑制 + T淋巴细胞　； 参考：《南京大学》2016年硕士论文

【摘要】：背景：胃癌一直是危害人类健康的重大疾病,我国的发病率一直居高不下,全球每年大约新发病例的50%出现在我国,而且我国胃癌患者绝大部分是进展期胃癌,治疗效果不甚理想。胃癌的治疗是以手术为主的综合治疗,但多年的临床实践证明,对进展期胃癌的疗效并非与手术范围的无限扩大成正比,因此术前化疗也就成为临床上治疗进展期胃癌的主要手段。我们采用动静脉结合的术前化疗治疗因局部进展严重而无法切除的胃癌患者。本研究目的是探究胃癌动静脉结合的术前化疗对病人T淋巴细胞亚群的影响。方法：选取局部进展严重且无法切除(ⅢB与ⅢC的105例胃癌患者,采用动静脉结的术前化疗共2周期,方案为FLEEOX。方法为：在第1～5天缓慢静脉滴注氟尿嘧啶370mmg/m2；第1-5天静滴亚叶酸钙200mg/m2；奥沙利120mg/lIl2、多柔比量30mg/In2以及足叶乙甙70mg/m2,分别在第6、 20天用动脉介入将导管插至腹腔干,而后将化疗药物注射到供给癌肿所在的血管内。化疗结束后复查全腹增强CT及外周血中T淋巴细胞抗原(CD3+ 、CD4+CD3+、CD8+CD3+、 CD4+/CD8+)及部分抗原比值。以肿瘤体积变化大小分成有效组和无效组。观察化疗前不同分期胃癌病人的T淋巴细胞抗原及部分抗原比值及化疗前后两组患者T淋巴细胞抗原及部分抗原比值的变化。结果：所有105例病人中,术前化疗有效率为78.1%(82/105)；化疗前ⅢC期患者与ⅢB期患者的外周静脉血中CD3+T淋巴细、CD4+CD3+ T淋巴细胞、CD8+CD3+ T淋巴细胞的百分比均值及CD4+/CD8+比值未见明显变化(P0.05)；有效组：化疗前与化疗后CD3+T淋巴细胞、CD4+CD3+T淋巴细胞、CD8+CD3+ T淋巴细胞的百分比均值均升高,差值具有统计学意义(P0.05)；无效组：化疗前与化疗后CD3+T淋巴细胞、CD4+CD3+ T淋巴细胞的百分比均值及CD4+/CD8+比值均升高,差值具有统计学意义(P0.05)。结论：局部进展严重的ⅢB与ⅢC期胃癌患者的细胞免疫功能无明显差异；术前动静脉结合化疗能够缓解肿瘤对宿主的免疫抑制。
[Abstract]:Background: gastric cancer has been a major disease endangering human health. The incidence of gastric cancer in China has been high. About 50% of the new cases in the world occur in China every year, and the majority of gastric cancer patients in China are advanced gastric cancer. The therapeutic effect is not satisfactory. The treatment of gastric cancer is based on surgical treatment, but clinical practice for many years has proved that the curative effect of advanced gastric cancer is not proportional to the unlimited expansion of the scope of surgery. Therefore, preoperative chemotherapy has become the main clinical treatment of advanced gastric cancer. We used preoperative chemotherapy combined with arteriovenous therapy for patients with unresectable gastric cancer due to severe local progression. The aim of this study was to investigate the effect of preoperative chemotherapy combined with arteriovenous therapy on T lymphocyte subsets in patients with gastric cancer. Methods: 105 patients with advanced and unresectable gastric cancer (鈪，

本文编号：2005219