摘要
背景与目的:胰腺癌发病隐匿,恶性程度高,预后极差。手术切除及术后化疗是最主要的治疗手段,但易导致患者免疫功能紊乱,尤其是细胞免疫功能下降。本研究观察胰腺癌患者根治性切除术前、术后、化疗前及化疗后细胞免疫功能的变化以及化疗患者在使用脾多肽后对机体细胞免疫功能的影响。方法:将73例2012年3月—2014年2月在复旦大学附属肿瘤医院行根治性切除术的胰腺癌患者随机分为2组:对照组(A组35例),采用吉西他滨(健择)单药化疗方案;用药组(B组38例),在吉西他滨单药化疗基础上联合脾多肽治疗。观察2组间手术前、后及化疗过程中T淋巴细胞亚群百分率、NK细胞百分率的变化。结果:胰腺癌患者术前细胞免疫功能较健康对照组显著降低,术后较术前则更显著降低,外周血CD3+、CD8+淋巴细胞百分率显著降低(P<0.05),CD4+淋巴细胞百分率与术前相比差异无统计学意义(P>0.05),CD4+/CD8+比值明显上升(P<0.05),NK细胞百分率反而明显升高(P<0.05);化疗前上述指标逐渐恢复至术前水平;化疗过程中患者细胞免疫功能再次受到抑制,CD3+、CD8+淋巴细胞百分率下降,CD4+/CD8+比值升高,4个疗程后逐渐恢复,而脾多肽用药组患者细胞免疫功能较对照组有不同程度的提高(P<0.05),未见明显抑制过程。结论:胰腺癌患者在手术、化疗等治疗过程中,细胞免疫功能受到抑制,脾多肽可作为胰腺癌患者术后化疗的辅助用药,纠正免疫功能紊乱,改善并促进机体细胞免疫功能恢复。
Background and purpose: Pancreatic cancer is one of the most aggressive and lethal human malignant diseases. The effective therapeutic approaches include surgical operation and chemotherapy, which could inhibit immune function of the patients, especially the cellular immunology function. The purpose of this study was to observe the clinical effect of gemcitabine combined with lienal polypeptide injection on cellular immunity activity of patients with chemotherapy after pancreatic radical resection. Methods: Seventy-three cases of radical resected pancreatic adenocarcinoma in Fudan University Shanghai Cancer Center during Mar. 2013 to Jan. 2014 were selected and randomized divided into gemcitabine chemotherapy group (Group A, 35 cases) and gemcitabine combined with lienal polypeptide injection chemotherapy group (Group B, 38 cases). The activities of T cells and NK cells were examined in both groups during pre- and post-operation, and chemotherapy process. Results: Cellular immunity activity was inhibited in patients with pancreatic adenocarcinoma, and further suppressed after operation, evidenced by the results that CD3+ and CD8+ lymphocytes percentages decreased significantly, the ratio of CD4+/CD8+ and percentage of NK cell increased significantly. The cellular immunity activity was inhibited again during the chemotherapy, however when combined with lienal polypeptide injection during chemotherapy, the activity of cellular immunity was improved (P〈0.05). Conelusion: Lienal polypeptide injection can improve the activity of immunity of the patients during the multimodality therapy of resected pancreatic adenocarcinoma.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2014年第12期906-913,共8页
China Oncology
基金
国家自然科学基金(81472670
81402397
81402398
81172005)
国家自然科学基金中德项目(GZ857)
关键词
脾多肽
胰腺癌
细胞免疫
化疗
Lienal polypeptide injection
Pancreatic cancer
Cellular immunity
Chemotherapy