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目的:探讨术前放化疗对低位直肠癌患者细胞免疫功能及保肛的影响。方法:将66例位直肠癌病例非随机同期临床分组,A组接受术前放化疗,B组术前行单纯化疗,C组术前未行放疗以及化疗。3组患者术前、术后均给予同样的营养支持治疗。统计各组的保肛率。采用流式细胞术(flowcytometry,FCM)检测3组病例治疗前、治疗后及术后第7天T细胞亚群百分率及NK细胞活性的变化。结果:全部病例均行直肠癌根治术。A组保肛率明显高于B组、C组,差异有统计学意义。3组病例治疗前、治疗后及术后T细胞亚群的百分率无明显变化;3组病例治疗后与治疗前相比,NK细胞活性也无明显变化;3组病例术后与治疗前、治疗后相比,NK细胞活性明显增高,差异有统计学意义;3组病例之间的比较,各项免疫指标的差异无统计学意义。结论:术前放化疗治疗低位直肠癌能明显改善症状、促进肿瘤的病理改变、提高保肛率,而且对机体免疫功能无明显影响,是一种安全有效、合理可行的新辅助治疗方法。
Objective: To investigate the effect of preoperative chemoradiotherapy on cellular immune function and anal sphincter preservation in patients with low rectal cancer. Methods: Sixty-six patients with rectal cancer were randomly divided into two groups: group A received preoperative chemoradiotherapy, group B received preoperative chemotherapy, group C received preoperative radiotherapy and chemotherapy. Three groups of patients were given the same nutritional support before and after surgery. Statistics anal sphincter rate. Flowcytometry (FCM) was used to detect the percentage of T cell subsets and NK cell activity before treatment, after treatment and on the 7th day after operation. Results: All cases underwent rectal cancer radical surgery. Group A anal sphincter rate was significantly higher than the B group, C group, the difference was statistically significant. There was no significant difference in the percentage of T cell subsets between the three groups before treatment, after treatment and after operation. There was no significant difference in NK cell activity between the three groups before and after treatment Compared with the control group, the NK cell activity was significantly increased, the difference was statistically significant. There was no significant difference among the three groups of immunological indexes. Conclusion: Preoperative chemoradiotherapy for low rectal cancer can significantly improve the symptoms, promote the pathological changes of the tumor, improve the anal sphincter rate, and have no significant effect on immune function. It is a safe, effective and reasonable neoadjuvant therapy.