新辅助化疗对老年食管癌残端癌阳性率及免疫功能的影响

来源 :武汉大学学报(医学版) | 被引量 : 0次 | 上传用户:hbzhwyf
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目的:探讨新辅助化疗对老年食管癌残端癌阳性率及免疫功能的影响。方法:以我院2008年7月至2013年7月间收治的180例老年局部晚期食管癌患者为研究对象,所有患者均进行手术治疗,观察组患者术前增加新辅助化疗。比较两组患者术后残端癌阳性率、围手术期免疫功能变化之间的差异。结果:观察组患者残端阳性率为0,对照组为6.67%,观察组高于对照组。在手术前,观察组患者IgA、IgG和IgM分别为(1.92±0.25)g/L、(9.84±0.75)g/L和(1.41±0.36)g/L,对照组为(2.27±0.56)g/L、(11.58±1.68)g/L和(1.81±0.20)g/L,在术后24h时,观察组三项分别为(1.74±0.12)g/L、(7.85±0.71)g/L和(1.21±0.21)g/L,对照组为(1.92±0.58)g/L、(10.05±0.98)g/L和(1.42±0.15)g/L,观察组患者低于对照组,但在术后7d时,两组患者IgA、IgG和IgM则无显著差异(P>0.05)。在T淋巴细胞的比较中,两组患者亦呈现与免疫球蛋白相同的规律。新辅助化疗会对患者免疫功能产生一定影响,但这种影响可在术后恢复。结论:新辅助化疗可以在老年食管癌手术治疗患者中起到积极作用,其并不会严重影响患者免疫功能,却能提高患者临床治疗效果,降低患者复发风险。 Objective: To investigate the effect of neoadjuvant chemotherapy on the positive rate and immune function of esophageal cancer stump cancer in the elderly. Methods: A total of 180 elderly patients with locally advanced esophageal cancer who were treated in our hospital between July 2008 and July 2013 were enrolled in this study. All patients underwent surgical treatment. Patients in the observation group received neoadjuvant chemotherapy before surgery. The differences between the two groups in postoperative stump cancer positive rate and perioperative immune function were compared. Results: The positive rate of stump in the observation group was 0, 6.67% in the control group, the observation group was higher than the control group. Before surgery, IgA, IgG and IgM in the observation group were (1.92 ± 0.25) g / L and (9.84 ± 0.75) g / L and (1.41 ± 0.36) g / L and / (11.58 ± 1.68) g / L and (1.81 ± 0.20) g / L, respectively. At 24h after operation, the three groups were (1.74 ± 0.12) g / L and (1.21 ± 0.21) g / L and (1.92 ± 0.58) g / L, (10.05 ± 0.98) g / L and (1.42 ± 0.15) g / L in the control group, At 7 days after operation, there was no significant difference in IgA, IgG and IgM between the two groups (P> 0.05). In the comparison of T lymphocytes, the two groups of patients also showed the same rules as immunoglobulins. Neoadjuvant chemotherapy may have an impact on immune function in patients, but this effect can be resumed after surgery. Conclusion: Neoadjuvant chemotherapy can play an active role in the elderly patients with esophageal cancer surgery, which does not seriously affect the immune function of patients, but can improve the clinical efficacy of patients and reduce the risk of relapse.
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