改良Miccoli微创术联合术后DC-CIK治疗甲状腺癌疗效及对患者血清Gal-3、sIL-2R水平的影响

Curative effect of modified Miccoli minimally invasive surgery combined with postoperative DC-CIK in the treatment of thyroid cancer and its effect on patients’ serum Gal-3 and Sil-2R levels

目的:探究改良Miccoli微创术联合术后树突状细胞-细胞因子诱导杀伤细胞(DC-CIK)治疗对甲状腺癌疗效及血清Gal-3、sIL-2R水平的影响。方法:将62例甲状腺癌治疗患者为研究对象,按照随机数字表法分为联合治疗组和手术治疗组,每组36例,手术治疗组患者仅采用改良的Miccoli微创手术进行治疗,联合治疗组则采用改良的Miccoli微创手术联合DC-CIK免疫疗法治疗,考察两组患者的临床疗效,治疗前及治疗2个月后,记录两组患者的Cyfra 21.1、sIL-2R和Gal-3等肿瘤指标水平和CD4+ Th17、CD4+CD+25Treg及Th17/Treg免疫指标水平。记录两组患者治疗6个月内的并发症发生情况。结果:治疗2个月后,联合治疗组有效率为88.89%,手术治疗组有效率为63.89%,联合治疗组临床有效率明显优于手术治疗组(P<0.05);治疗后,联合治疗组的Cyfra 21.1和Gal-3水平明显高于手术治疗组(P<0.05),sIL-2R水平明显低于手术治疗组,差异具有统计学意义(P<0.05);较之于手术治疗组,联合治疗组的CD4+CD■Treg及Th17/Treg水平更高,CD4+ Th17水平明更低,差异具有统计学意义(P<0.05);手术治疗组喉上、喉返神经麻痹、甲状旁腺功能障碍、肿瘤复发等并发症发生率为16.67%,联合治疗组为2.78%,两组比较差异有统计学意义(P<0.05)。结论:对甲状腺癌患者采用改良Miccoli微创术联合术后DC-CIK治疗能显著抑制患者病情,改善其不良预后。

Objective:To explore the curative effect of modified Miccoli minimally invasive surgery combined with postoperative dendritic cell-cytokine-induced killer cell(DC-CIK) in the treatment of thyroid cancer and its effect on patients’ serum Gal-3 and sIL-2 R levels.Methods:62 patients with thyroid cancer treated were selected and divided into combined treatment group and surgical treatment group according to a random number table,with 36 cases in each group.The surgical treatment group were treated with only modified Miccoli minimally invasive surgery,and the combined treatment group was treated with modified Miccoli minimally invasive surgery combined with DC-CIK immunotherapy.The clinical efficacy of the two groups of patients was investigated.Before treatment and 2 months after treatment,the levels of Cyfra 21.1,sIL-2 R,Gal-3 CD4+ Th17,CD4+CD+ 25Treg and Th17/Treg of the two groups were recorded.The complications of the two groups of patients within 6 months of treatment were recorded.Results:After 2 months of treatment,the effective rate of the combined treatment group was 63.89%,the effective rate of the surgical treatment group was 88.89%,and the clinical effective rate of the combined treatment group was significantly better than that of the surgical treatment group(P<0.05).After treatment,Cyfra 21.1 and Gal-3 levels in the combined treatment group were significantly higher than those in the surgical treatment group(P<0.05),and sIL-2 R level was significantly lower than that in the surgical treatment group(P<0.05).Compared with the surgical treatment group,CD4+CD+ 25Treg and Th17/Treg levels in the combined treatment group were higher,and CD4+ Th17 level was lower(P<0.05).The incidence of complications such as superior laryngeal palsy,recurrent laryngeal nerve palsy,parathyroid dysfunction and tumor recurrence was 16.667% in the surgical treatment group and 2.78% in the combined treatment group,with statistically significant difference(P<0.05).Conclusion:Modified Miccoli minimally invasive surgery combined with postoperative DC-CIK treatment for patients with thyroid cancer can significantly inhibit the patient’s condition and improve its poor prognosis.