术前放化疗对中晚期食管癌免疫功能的影响

Effects of neoadjuvant chemotherapy on immunity in patients with resectable adanced esophageal cancer

目的:分析术前放化疗对中晚期食管癌围手术期免疫功能的影响。方法:选取广西医科大学附属肿瘤医院2008年1月至2011年1月收治138例患者,按照治疗方法分成2组,NCRT组予以放化疗联合手术,S组予以单纯手术组。分析两组有效率、治疗前、后及手术后免疫功能变化。结果:NCRT组CD4+/CD8+及NK细胞,放化疗后均显著降低(P<0.05);术后7日,均较放化疗后显著提高(P<0.05),但总体较放化疗前显著降低(P<0.05)。两组术后7日CD4+/CD8+无显著差异,且均显著低于放化疗/术前(P<0.05);术后7日NCRT组NK细胞显著高于S组(P<0.05)。NCRT组中有效组在放化疗后,NK细胞均较前显著增高(P<0.05),CD4+/CD8+无明显改变(P>0.05)。而无效组在放化疗后,NK细胞和CD4+/CD8+均较前显著降低(P<0.05)。结论:NCRT联合手术对中晚期食管癌免疫功能有一定抑制作用,对NCRT敏感者免疫功能影响不大,却能显著降低不敏感者免疫功能。

Objective：To explore the changes of immunity function before and after neoadjuvant therapy in the treatment of resectable Advanced Esophageal Cancer（AEC）.Methods： A total of 138 patients with locally advanced （T3-4NXM0） AEC were studied. They were allocated to two groups： surgery alone （S-group） or Neoadjuvant chemoradiotherapy followed by surgery （NCRT-group）.Results： The function of immunity were significantly lower in AEC patients after NCRT（P0.05）,whereas,T-lynphocyte subgroup immunity were significantly higher after surgery（P0.05） and there were no significant different between two groups（P0.05）.NK cells were higher in efective group than those in pre-treatment samples（P0.05）,CD4＋/CD8＋ didnt change（P0.05）.However,in invalid group NK cell and CD4＋/CD8＋were lower than those in pre-treatment patients （P0.05）.Conclusion： The immunity was suppressed in patients with AEC. CD4＋/CD8＋ have no change significantly in efective group,but it changes markedly in invalid group.