沉默免疫负调控基因技术联合辅助化疗治疗结肠癌的回顾性分析

Retrospective analysis of the cell therapy of inhibition of antigen-presentation attenuators combined with adjuvant chemotherapy in the treatment of colon cancer

目的探讨沉默免疫负调控基因技术(iAPA)联合辅助化疗治疗结肠癌的临床效果及安全性。方法选取温州市人民医院2014年2月至2015年10月治疗的结肠癌患者40例为研究对象,对患者临床资料进行回顾性分析,根据治疗方案不同分为对照组和研究组,每组20例。对照组采取mFOLFOX6方案化疗(治疗6个月),研究组在对照组基础上采取iAPA治疗(治疗6个周期)。比较两组临床疗效、治疗前及疗程结束后免疫功能指标(CD3+、CD4+、CD8+、CD4+/CD8+)水平、毒副反应发生率、生活质量(QOL)分值,统计两组生存率。结果研究组总有效率高于对照组(85.0%比55.0%,χ^2=4.286,P<0.05);疗程结束后研究组血清CD3+、CD4+、CD8+、CD4+/CD8+水平均高于对照组,CD8+水平低于对照组,差异均有统计学意义(t=2.657、3.160、5.700、2.326,均P<0.05);两组均未发生Ⅳ度毒副反应,研究组腹泻(25.0%)、呕吐恶心(20.0%)、肝功能损伤(25.0%)、骨髓抑制(25.0%)发生率均低于对照组(χ^2=5.013、5.227、5.013、6.465,均P<0.05);疗程结束后两组QOL分值较治疗前升高,且研究组高于对照组(t=4.739,P<0.05);治疗后24个月、30个月研究组生存率均高于对照组(χ^2=5.013、4.912,均P<0.05)。结论采取iAPA联合辅助化疗治疗结肠癌可调节患者机体免疫功能,提高疾病治疗效果,利于改善患者生活质量、延长生存期限,且可降低毒副反应发生率,具有安全性。

Objective To investigate the clinical effect and safety of the cell therapy of inhibition of antigen-presentation attenuators(iAPA) combined with adjuvant chemotherapy in the treatment of colon cancer. Methods From February 2014 to October 2015,the clinical data of 40 patients with colon cancer in the People's Hospital of Wenzhou were analyzed retrospectively.They were divided into control group and study group by the random digital table,with 20 cases in each group.The control group received mFOLFOX6 chemotherapy(treatment for 6 months),and the study group was treated with iAPA on the basis of the control group (treatment for 6 cycle).The clinical efficacy,levels of immune function indicators (CD3+ ,CD4+ ,CD8+ ,CD4+ /CD8+ ) before treatment and after treatment,the incidence of toxic and side effects and quality of life (QOL) score of the two groups were recorded.And the survival rates were statistically analyzed. Results The total effective rate of the study group was higher than that of the control group(85.0% vs.55.0%,χ2=4.286,P<0.05).After treatment,the serum levels of CD3+ ,CD4+ ,CD8+ ,CD4+ /CD8+ in the study group were higher than those in the control group,while the serum level of CD8+ was lower in the study group than that in the control group,the differences were statistically significant(t=2.657,3.160,5.700,2.326,all P<0.05).There were no side effects of the degree of Ⅳ in the two groups.The incidence rates of diarrhea(25.0%),vomiting and nausea(20.0%),liver function damage(25.0%) and bone marrow suppression(25.0%) in the study group were lower than those in the control group(χ2=5.013,5.227,5.013,6.465,all P<0.05).After treatment,the QOL scores of the two groups were higher than those before treatment(all P<0.05),and the QOL score of the study group was higher than that of the control group(t=4.739,P<0.05).The survival rate of the study group was higher than that of the control group after 24 and 30 months of treatment(χ2=5.013,4.912,all P<0.05). Conclusion The iAPA combined with adjuvant chemotherapy in the treatment of colon cancer can regulate the immune function of the patients,and improve the treatment effect of the disease.It helps to improve the QOL and prolong the life period of the patients,reduce the incidence of side effects,and it is safe.