射频消融术联合放化疗治疗晚期肺癌的疗效及其对CT灌注成像、T淋巴细胞亚群的影响

The efficacy of radiofrequency ablation combined with radiotherapy and chemotherapy in the treatment of advanced lung cancer and its impact on CT perfusion imaging and T lymphocyte subsets

目的观察射频消融术联合放化疗治疗晚期肺癌的疗效及其对CT灌注成像、T淋巴细胞亚群的影响。方法收集2010年12月—2014年3月河北省沧州市人民医院、河北医科大学第四医院就诊的晚期肺癌患者220例,按随机数字表法分为试验组和对照组,每组110例。对照组仅给予单纯射频消融术治疗,试验组给予射频消融术+放化疗治疗,观察2组患者治疗的疗效及对CT灌注成像、T淋巴细胞亚群的影响。结果治疗后试验组患者的总有效率明显优于对照组(72.72%vs.42.73%,χ~2=8.932,P<0.05)。试验组治疗后血流量(BF)、血容量(BV)和表面通透性(PS)等CT灌注成像指标均低于对照组,平均通过时间(MTT)高于对照组,差异均有统计学意义(t=-15.019、-15.165、9.761、-11.529,P<0.05);试验组治疗后CD3^+、CD4^+、CD8^+及CD4^+/CD8^+水平亦高于对照组,差异均有统计学意义(t=17.159、12.275、13.573、6.384,P<0.05)。结论射频消融术联合放化疗治疗肺癌可显著降低肺癌血供,且对免疫系统影响较小,具有积极的治疗意义。

Objective To investigate the efficacy of radiofrequency ablation combined with radiotherapy and chemo -therapy in the treatment of lung cancer and its impacts on CT perfusion imaging and T lymphocyte subsets .Methods From December2010 to March 2014 , 220 patients with advanced lung cancer accepting treatment in our hospital were randomly di -vided into experimental group and control group , 110 cases in each group.The control group was treated with radiofrequency ablation only , while the experimental group was treated with radiofrequency ablation and radiotherapy and chemotherapy .To observe the clinical value of the treatment of the two groups of patients and the impacts on CT perfusion imaging , T lymphocyte subsets.Results After treatment, the total effective rate in experimental group was superior to that of control group （ 72.72%vs.42.73%,χ^2=8.932, P 〈0.05）.CT perfusion imaging parameters such as BF , BV and PS in the experimental group were all lower than those in the control group , while MTT was higher than that in the control group , the differencees were sta-tistically significant （ t =-15.019, -15.165, 9.761, -11.529, P 〈0.05）; And the levels of CD3 ^＋, CD4^＋, CD8^＋T and CD4 ^＋/CD8^ ＋lymphocytes were higher than those in the control group , the differences were statistically significant （ t =17.159, 12.275, 13.573, 6.384, P 〈0.05）.Conclusion Radiofrequency ablation combined with radiotherapy and chemo -therapy can significantly reduce blood supply for lung cancer , and has little impact on the immune system with a positive thera-peutic significance .