低位直肠癌应用腹腔镜手术联合新辅助化疗对血清CEA、VEGF、CA724、CA242、LEP水平及免疫功能的影响

Effect of laparoscopic surgery combined with neoadjuvant chemotherapy on serum CEA,VEGF,CA724,CA242,LEP and T lymphocyte subsets in patients with low rectal cancer

目的:探讨低位直肠癌应用腹腔镜手术联合新辅助化疗对血清癌胚抗原(carcinoembryonic antigen,CEA)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、糖类抗原724(carbohydrate antigen 724,CA724)、糖类抗原242(carbohydrate antigen 242,CA242)、瘦素(leptin,LEP)水平及免疫功能的影响。方法:选择我院收治的100例低位直肠癌患者,随机分为对照组和治疗组各50例。对照组患者给予腹腔镜手术治疗,治疗组患者给予新辅助化疗联合腹腔镜手术治疗,术后两组均继续给予新辅助化疗6个疗程。比较两组血清CEA、VEGF、CA724、CA242及LEP水平及外周血CD3+、CD4+、CD8+及NK细胞所占比值的治疗前后结果。结果:两组治疗前血清CEA、VEGF、CA724、CA242及LEP水平比较,无显著性差异(P>0.05);两组治疗后血清CEA、VEGF、CA724、CA242及LEP水平相比治疗前偏低,且以上血清指标治疗组相比对照组偏低,均具有显著性差异(P<0.05)。两组治疗后外周血CD3+、CD4+、CD8+及NK细胞所占比值相比治疗前均明显偏低,治疗组外周血CD3+、CD4+、CD8+及NK细胞所占比值相比对照组偏高,均具有显著性差异(P<0.05)。结论:腹腔镜手术联合新辅助化疗能够明显降低低位直肠癌患者血清CEA、VEGF、CA724、CA242及LEP水平,改善机体免疫功能,值得在临床上推广应用。

Objective：To study the effect of laparoscopic surgery combined with neoadjuvant chemotherapy on serum CEA,VEGF,CA724,CA242,LEP and T lymphocyte subsets in patients with low rectal cancer.Methods：A total of 100 patients with low rectal cancer in our hospital were enrolled in this study.The subjects were randomly divided into the control group（n=50）and the treatment group（n=50）.The control group was treated with laparoscopic surgery,and the treatment group was treated with laparoscopic surgery combined with neoadjuvant chemotherapy,both groups were treated with neoadjuvant chemotherapy after surgery for 6periods.The serum CEA,VEGF,CA724,CA242,LEP levels and peripheral bloodCD3＋,CD4＋,CD8＋,NK cells of the two groups before and after treatment were compared.Results：There were no significantly differences of the serum CEA,VEGF,CA724,CA242 and LEP levels of the two groups before treatment（P〈0.05）.The serum CEA,VEGF,CA724,CA242 and LEP levels of both groups after treatment were lower than those before treatment（P〈0.05）,and these serum levels of the treatment group were lower than those of control group（P〈0.05）.After treatment,the peripheral blood CD3＋,CD4＋,CD8＋and NK cells of both groups were significantly lower than those before treatment（P〈0.05）,and these of the treatment group were higher than those of control group（P〈0.05）.Conclusion：Laparoscopic surgery combined with neoadjuvant chemotherapy can significantly reduce the serum CEA,VEGF,CA724,CA242 and LEP levels,improve the immunologic function,and it was worthy of clinical application.