自身免疫细胞与放疗联合治疗对宫颈癌患者生活质量和免疫功能的影响

Influence of self-immune cell therapy combined with radiotherapy on the quality of life and immune function of patients with cervical cancer

目的探讨自身免疫细胞与放疗联合治疗宫颈癌临床疗效,分析对宫颈癌患者生活质量及免疫功能的影响。方法选取2012年5月至2015年6月浙江大学医学院附属第二医院放疗科收治的85例宫颈癌患者为研究对象,分为对照组（n=42）和观察组（n=43）,对照组患者单纯放疗,观察组给予自身免疫细胞与放疗联合治疗,观察各组临床疗效,比较治疗前后两组患者免疫功能及治疗后生活质量。结果观察组总有效率为86.05%,对照组为64.28%,两组比较具有统计学差异（χ2=5.409,P=0.02）。对照组治疗后CD3＋、CD4＋、CD8＋细胞绝对值明显低于治疗前（t值分别为11.036、7.624、14.379,均P〈0.05）,观察组明显高于治疗前（t值分别为15.996、12.241、13.981,均P〈0.05）,治疗后两组CD3＋、CD4＋、CD8＋细胞绝对值比较有统计学差异（t值分别为22.758、20.839、27.140,均P〈0.05）。治疗后两组患者生存质量评分均明显高于治疗前（t对照组值分别为3.378、4.022、3.320、3.864,t观察组值分别为6.984、7.289、5.389、7.017,均P〈0.05）,观察组治疗后生存质量评分显著高于对照组（t值分别为3.609、3.386、3.009、4.417,均P〈0.05）。治疗后Ⅰ~Ⅱ期、Ⅲ~Ⅳ期两组患者生存质量评分均明显高于治疗前（tⅠ~Ⅱ期值分别为8.843、5.040、9.026、3.864,tⅢ~Ⅳ期值分别为5.534、5.314、9.604、10.210,均P〈0.05）,治疗后生存质量评分Ⅰ~Ⅱ期高于Ⅲ~Ⅳ期（t值分别为4.216、3.391、5.895、4.812,P〈0.05）。对照组出现骨髓抑制3例,消化道反应3例,观察组出现消化道反应3例,两组不良反应发生率比较无统计学差异（χ2=1.199,P=0.271）。结论自身免疫细胞与放疗联合治疗宫颈癌临床疗效显著,可通过提高患者免疫功能,提升患者生活质量。

Objective To explore the clinical efficacy of self-immune cell therapy combined with radiotherapy as well as their influence on the quality of life and immune function of patients with cervical cancer. Methods A total of 85 patients with cervical cancer admitted from May 2012 to June 2015 in the Second Affiliated Hospital of Zhejiang University Medical College were selected in study,and they were divided into control group（ n = 42） and observation group（ n = 43）. Patients in the control group were given radiotherapy treatment,while patients in the observation group were given self-immune cell therapy combined with radiotherapy. The clinical efficacy,immune function and quality of life after treatment were compared between two groups. Results After treatment,the total effective rate was 86. 05% and64. 28% in the observation group and the control group,respectively,and the difference was significant（ χ2= 5. 409,P = 0. 020）.Compared with those before treatment,the absolute values of CD3＋,CD4＋and CD8＋cells in the control group were lower（ t value was11. 036,7. 624 and 14. 379,respectively,all P〈0. 05）,while they were higher in the observation group after treatment（ t value was15. 996,12. 241 and 13. 981,respectively,all P〈0. 05）. The absolute value of CD3＋,CD4＋and CD8＋cells after treatment in two groups showed significant differences（ t value was 22. 758,20. 839 and 27. 140,respectively,all P〈0. 05）. The quality of life scores after treatment were significantly higher than before treatment in two groups（ t value was 3. 378,4. 022,3. 320 and 3. 864,respectively in the control group and t value was 6. 984,7. 289,5. 389 and 7. 017,respectively in the observation group,all P〈0. 05）,and they were significantly higher in the observation group than in the control group（ t value was 3. 609,3. 386 3. 009 and 4. 417,respectively,all P〈0. 05）. After treatment,quality of life score in patients of stage Ⅰ- Ⅱand those of Ⅲ- Ⅳ were higher than those before treatment（ t value was 8. 843,5. 040,9. 026 and 3. 864,respectively in Ⅰ- Ⅱ stage and t value was 5. 534,5. 314,9. 604 and 10. 210,respectively in Ⅲ- Ⅳ stage,all P〈0. 05）. After treatment the quality of life scores of patients of stageⅠ- Ⅱ were higher than those of patients of stage Ⅲ- Ⅳ（ t value was 4. 216,3. 391,5. 895 and 4. 812,respectively,all P〈0. 05）. In the control group there were 3 cases of myelosuppression and 3 cases with digestive tract reaction. There were only 3 cases with digestive tract reaction in the observation group.The incidence of adverse reactions was not statistically significant between two groups（ χ2= 1. 199,P = 0. 271）. Conclusion Clinical efficacy of self-immune cell therapy combined with radiotherapy in treatment of cervical cancer is significant,which can enhance the quality of life by improving immune function in patients.