同步放化疗对食管癌患者T淋巴细胞亚群及自然杀伤细胞的影响

Influence of concurrent chemoradiotherapy on T-lymphocyte subsets and natural killer cells of patients with esophageal carcinoma

目的:观察同步放化疗对食管癌患者T淋巴细胞亚群及自然杀伤(NK)细胞的影响。方法:选取85例食管癌患者设为食管癌组,并随机分为单纯放疗组(单放组)40例和同步放化疗组45例,另随机选取同期健康体检者40例设为对照组。单放组采用单纯放射治疗,同步放化疗组加用顺铂20mg·m-2·d-1+紫杉醇40mg·m-2·d-1。结果:食管癌组T淋巴细胞总量(T总)、辅助性T细胞(Th)、抑制性T细胞(Ts)比例及Th/Ts与对照组比较,差异均具有统计学意义(P<0.01);NK细胞比较,差异无统计学意义(P>0.05)。同步放化疗组治疗有效率明显高于单放组,差异具有统计学意义(P<0.05)。治疗后两组T总、Th比例及Th/Ts均明显升高,Ts比例明显降低,差异具有统计学意义(P<0.01);NK比较,差异无统计学意义(P>0.05);组间比较,同步放化疗组T总、Th比例及Th/Ts均明显高于单放组,差异具有统计学意义(P<0.05或P<0.01)。结论:食管癌患者细胞免疫功能低下,同步放化疗较单纯放疗能明显提高其T总、Th比例及Th/Ts值,改善免疫功能。

Objective： To explore the influence of concurrent chemoradiotherapy on T-lymphocyte subsets and natural killer cells （NKC） of patients with esophageal carcinoma. Methods：A total of 85 patients with esophageal carcinoma were selected as esophageal group and randomly divided into simple radiotherapy group （40 cases） and concurrent chemoradiotherapy group （45 cases）. Forty cases who conducted health examination in the same period were selected as control group. Radiother- apy alone was given to simple radiotherapy group while concurrent chemoradiotherapy group added with 20 mg/（m^2· d） of cisplatin and 40 mg/（m^2 · d） of paclitaxeh Results：Total T lymphocytes, helper T cell （Th）, suppressor T ceils （Ts） and Th/ Ts in esophageal group were significantly different from control group （P〈0.01） and there was no significant differences in NKC between the two groups （P〉0.05）. Response rate in concurrent chemoradiotherapy group was significantly higher than in simple radiotherapy group （P〈0.05）, and there were significant differences before and after treatment and between twogroups in Total T lymphocytes, Th and Th/Ts （P〈0.05 or P〈0.01）. Conclusions：Cellular immune function in patients with esophageal carcinoma is insufficient, concurrent chemoradiotherapy can improve the proportion of Total T lymphocytes, Th and Th/Ts and boost immune function.