术前联合放化疗及单一化疗对直肠癌患者免疫功能、保肛率及不良反应发生率的影响

Immune and sphincter preservation rate in patients with colorectal cancer after preoperative radiotherapy combined with chemotherapy or chemotherapy alone

目的比较术前联合放化疗及单一化疗对直肠癌患者的免疫功能、保肛率及不良反应发生情况。方法选取2015年来我院就诊的81例直肠癌患者为研究对象。患者自愿选择治疗的方式,分为术前放疗联合化疗组(联合组)41例和单一化疗组(单一组)40例。在手术开始前与术后一周后分别抽取静脉血,检测免疫细胞群体水平,并比较两组手术时间、术后保肛情况及不良反应发生情况。结果治疗前后两组患者免疫细胞群体水平组内、组间比较差异均无统计学意义(P>0.05);两组手术时间比较,差异无统计学意义(P>0.05);联合组保肛率显著高于单一组(P<0.05);两组不良反应发生情况比较无显著差异(P>0.05)。结论在直肠癌患者中,术前予以联合放化疗较单一化疗能显著提高术后保肛率,且对机体免疫细胞群体影响小,不增加不良反应发生率,具有一定的实用价值。

Objective To study Immune and sphincter preservation rate in patients with colorectal cancer after preoperative radiotherapy combined with chemotherapy or chemotherapy alone. Methods 81 patients with colorectal cancer in 2015 who came to our hospital, divided into before preoperative radiotherapy combined with chemotherapy group（combined group） and 41 cases of a single chemotherapy group（single group） 40 cases. Single group before undergoing colorectal cancer surgery, the first injection given fluorouracil and injectable left leucovorin. And combined group add to radiation therapy. Before the start of surgery and after a week venous blood,respectively, detection of immune cell population level, as a comparative reference index. Record each patient undergoing surgery, postoperative anal sphincter preservation in cases, cases of adverse reactions were checked for registration. Results Two groups of patients after treatment end of the week, respectively, before the treatment and comparison groups of immune cells found in all the patients had no significant change（P〉0.05）, there were no statistically significant difference between the two（ P〉0.05）. The two groups were compared in general surgery, found that the overall operation time and will not happen significant changes, small differences（P〉0.05）, but the combined group sphincter preservation rate is up to 80.49%, significantly higher than a single group（P〉0.05）. While the comparison of two groups of patients with adverse reactions found in the combination group exists nausea, vomiting, diarrhea, decreased white blood cell count level infection, the incidence of51.22%, 43.90%, 36.58% and 21.95%, respectively, are slightly larger than a single set all kinds adverse reactions occur, but the difference was not statistically significant（P〉0.05）. Conclusion Preoperative chemotherapy combined treatment of patients with colorectal cancer, compared to chemotherapy alone, significantly improved sphincter preservation rate, and does not affect the immune cell population imbalance, without increasing the incidence of adverse reactions.