温热灌注化疗对结直肠癌患者免疫指标的影响

Influence of hyperthermic perfusion chemotherapy on immune indexes in patients with colorectal cancer

目的评价腹腔内温热灌注化疗对结直肠癌术后外周血中免疫指标的影响。方法将2010-01~2013-12以来手术切除的50例Dukes B^C期的结直肠癌患者随机分成温热灌注化疗组及常温灌注化疗组。温热灌注化疗组在手术结束后用含氟尿嘧啶(5-FU)0.5 g/L、丝裂霉素(MMC)8 mg/L、奥沙利铂25 mg/L温热蒸馏水4 000 ml,温度控制在43~45℃,在腹腔灌洗1 h。常温灌注化疗组在手术结束后用含5-FU 0.5 g/L、丝裂霉素(MMC)8 mg/L、奥沙利铂25 mg/L常温蒸馏水4 000 ml,温度控制在25~30℃,在腹腔灌洗1 h。然后两组分别于术后1月、术后2月再次腹腔灌洗,两组患者均于治疗前、术中、术后1月、术后2月应用ELISA法测定两组患者外周血中IL-2、TNF-α水平。结果与常温灌注化疗组相比,温热灌注化疗组的患者外周血中IL-2、TNF-α水平均明显升高,差异有统计学意义(P<0.05)。结论腹腔内温热灌注化疗可促进Thl型免疫漂移,增强机体的抗肿瘤免疫功能,对预防和治疗结直肠癌腹腔内复发与肝转移有一定的作用。

Objective To evaluate the influence of intraperitoneal hyperthermic peffusion chemotherapy on immune indexes in peripheral blood in postoperative patients with eolorectal cancer. Methods From Jannary 2010 to December 2013,50 patients with DukesB - C eoloreetal cancer were randomly divided into two groups：the hyperther- mie perfusion chemotherapy group and the normal temperature peffusion chemotherapy group. After surgery byperther- mie perfusion chemotherapy group received intraperitoneal hyperthermic distilled water（43 -45 ℃ ） perfusion contai- ning fluorouracil（5-FU）0. 5 g/L,mitomycinC（MMC） 8 mg/L oxaliplatin 25 mg/L in 4 000 ml distilled water for 1 hour; the normal temperature perfusion group received intraperitoneal normal temperature distilled water（ 25 -30 ℃ ） peffusion containing above drugs in 4 000 ml distilled water for 1 hour. The same perfusions were performed at 1 and 2 months after operation in two groups. Before operation,during operation and at 1 and 2 months after operation IL-2 and TNF-α in peripheral blood were measured by ELISA in two groups. Results Compared with normal temperature peffusion chemotherapy group, the levels of IL-2 and TNF-α in hyperthermic perfusion chemotherapy group were sig- nificantly increased,and the difference was statistically significant （P 〈 0. 05 ）. Conclusion Intraperitoneal hypcr- thermie perfusion chemotherapy may promote Thl-type immune drift, enhance the body＇s anti-tumor imnlune function, and have a certain role in prevention and treatment of the peritoneal recnrrence and metastases of eolorectal cancer.