FolFox方案新辅助化疗对Ⅱ、Ⅲ期大肠癌手术患者血T-细胞亚群的影响

The impact of neoadjuvant chemotherapy with Folfox on T lymphoyte subsets in patients withⅡ , Ⅲstage colorectal carcinoma

目的探讨FolFox方案新辅助化疗对Ⅱ、Ⅲ期大肠癌手术患者血T-细胞亚群的影响并作对比研究。方法入组65例大肠癌患者全部行FolFox方案新辅助化疗,1周后行根治性手术,全部保肛成功。根据术后病理检查结果再分组:Ⅱ期组大肠癌患者36例,Ⅲ期组大肠癌患者29例。采用流式细胞术分别检测两组患者新辅助化疗前1d、术后第7天及术后14d外周血T-细胞亚群水平(CD3+、CD4+、CD8+、CD4+/CD8+)并进行对比。同时检测40例正常健康人的外周血T-细胞亚群作为健康组分别进行比较。结果新辅助化疗前Ⅱ期组、Ⅲ期组患者及健康组外周血T-细胞亚群水平比较,差异均无统计学意义(P>0.05);术后7dⅡ期组及Ⅲ期组患者外周血T-细胞亚群水平均下降,Ⅲ期组下降明显,差异有统计学意义(P<0.05);术后14dⅡ期组及Ⅲ期组患者外周血T细胞亚群水平均有所恢复,Ⅲ期组恢复较慢,差异有统计学意义(P<0.05)。结论经FolFox方案新辅助化疗对Ⅱ、Ⅲ期大肠癌患者血清T-细胞亚群水平均有影响,尤其对Ⅲ期大肠癌患者影响更大,对免疫功能存在不利影响。

Objective To investigate the neoadjuvant chemotherapy of FolFox regimen onⅡ,Ⅲ stage colorectal cancer operation patients blood T-cell subgroup effects and make a comparison study.Methods 65cases of patients with colorectal cancer,underwent neoadjuvant chemotherapy of FolFox regimen,1week after radical operation,all retention of anus success.According to the postoperative pathological results,more accurate grouping：Ⅱstage 36cases andⅢstage 29cases.Flow cytometry were used to detect the two groups of patients treated with neoadjuvant chemotherapy before 1days,after seventh days and 14days after transplantation of peripheral blood T lymphocyte cell subsets（CD3＋,CD4＋,CD8＋,CD4＋/CD8＋）and contrast.Detection of 40cases healthy human peripheral blood T lymphocyte cell subsets as health group to compare.Results PhaseⅡ andⅢ group of patients treated with neoadjuvant chemotherapy before peripheral blood T lymphocyte cell subsets level contrast,at the same time with the healthy group,the differences were not statistically significant（P〈0.05）;stageⅡand stageⅢgroup 7days after operation in patients with peripheral T-cell subsets levels fell,stageⅢgroup decreased obviously,both of the results and compared the difference was statistically significant（P〈0.05）;stageⅡand stageⅢgroup 14days after operation in patients with peripheral T-cell subsets levels have recovery,stageⅢ group recovery was slower,compared the differences were statistically significant（P〈0.05）.Conclusion The FolFox regimens as neoadjuvant chemotherapy for colorectal cancer stageⅡ,serum levels of T lymphocyte subsets are affected,especially for colorectal cancerⅢstage for greater impact,results in significant,prompting FolFox schemes in the neoadjuvant chemotherapy in the treatment of colorectal cancer in different stages in the process,on the immune function of patients with influence in the presence of adverse effects,clinical with stageⅢ colorectal cancer immune therapy over time in order to improve the clinical treatment effect.