胃癌患者腹腔热灌注联合全身静脉化疗的临床效果及对免疫功能的影响

Effect of intraperitoneal hyperthermic perfusion chemotherapy on clinical efficacy and immune function in patients with gastric cancer

目的探讨胃癌患者采用腹腔热灌注联合全身静脉化疗的临床效果及对免疫功能、癌胚抗原(CEA)、糖链抗原19-9(CA19-9)水平的影响。方法选取2013年12月至2018年12月间陕西安康市中医医院收治的80例胃癌患者,按照术后化疗方法不同分为观察组和对照组,每组40例。观察组患者采用腹腔热灌注化疗^+全身静脉化疗,对照组患者采用全身静脉化疗,比较两组患者化疗效果、治疗前后免疫功能(CD3^+、CD4^+和CD8^+、CD4^+/CD8^+水平)、血清CEA、CA19-9水平和不良反应的发生情况。结果观察组患者总有效率为67.5%,高于对照组的45.0%,两组比较,差异有统计学意义(P<0.05)。治疗后,两组患者CD3^+、CD4^+、CD4^+/CD8^+水平均较治疗前升高,CD8^+水平降低,且观察组患者CD3^+、CD4^+和CD4^+/CD8^+水平高于对照组,CD8^+水平低于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者CEA和CA19-9水平降低,且观察组均低于对照组,差异均有统计学意义(均P<0.05)。两组患者均发生烫伤、骨髓抑制、恶心呕吐、肝肾功能损伤、脱水、皮疹和便秘等不良反应,但发生率比较,差异无统计学意义(P<0.05)。结论腹腔热灌注联合全身静脉化疗对胃癌患者疗效较好,可改善患者免疫功能,降低血清CEA和CA19-9水平,安全性高,值得临床推广。

Objective To explore the effect of intraperitoneal hyperthermic perfusion chemotherapy on immune function and the levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)in patients with gastric cancer.Methods Eighty patients with gastric cancer who admitted to Ankang Hospital of Traditional Chinese Medicine from December 2013 to December 2018 were selected as the research subjects.They were divided into an observation group and a control group according to the postoperative chemotherapy methods with 40 patients in each group.The observation group was given intraperitoneal hyperthermic perfusion chemotherapy plus systemic intravenous chemotherapy while the control group was given systemic intravenous chemotherapy.The efficacy of chemotherapy,The immune function including levels of CD3^+,CD4^+,CD8^+,and CD4^+/CD8^+,serum CEA and CA19-9 levels,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results The overall efficacy rate was 67.5%in the observation group,which was higher than 45.0%of the control group(P<0.05).After the treatment,the levels of CD3^+,CD4^+and CD4^+/CD8^+increased in the two groups,while the levels of CD8^+decreased(all P<0.05).The levels of CD3^+,CD4^+and CD4^+/CD8^+were higher in the observation group than in the control group,and the levels of CD8^+were lower in the observation group than in the control group(all P<0.05).After the treatment,the levels of CEA and CA19-9 decreased significantly in the two groups with the observation group lower than the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions such as scald,bone marrow suppression,nausea and vomiting,liver damage and kidney disfunction,dehydration,rash and constipation between the two groups(P>0.05).Conclusion Intraperitoneal hyperthermic perfusion combined with systemic intravenous chemotherapy is effective for gastric cancer.It can significantly improve the immune function,reduce the levels of serum CEA and CA19-9 with high safety.It is worthy of clinical promotion.