肺癌患者采取外科手术结合免疫治疗对患者炎性因子及临床康复效果的影响

The effect of surgery combined with immunotherapy on inflammatory factors and clinical rehabilitation in patients with lung cancer

目的:探讨肺癌患者采取外科手术结合免疫治疗对患者炎症因子及临床康复的影响,为患者的诊疗提供指导。方法:选取江油九〇三医院2016年1月~2018年12月收治的肺癌患者91例进行研究。按照随机数表法,将所有患者分为两组。对照组46例,仅使用外科手术治疗,观察组45例,采用外科手术结合免疫治疗。观察比较两组患者治疗前后炎症因子肿瘤坏死因子α(TNF-α)、淀粉样蛋白A(SAA)、白细胞介素6(IL-6)、C反应蛋白(CRP)水平,免疫细胞因子免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)及外周血T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)、CD3^(+)/CD8^(+)水平变化情况,并比较治疗后两组患者治疗后疾病控制率(DCR)、客观反应率(ORR)。结果:观察组ORR(45.22%)、DCR(82.22%)均明显高于对照组(21.74%、58.70%),差异有统计学意义。观察组治疗后炎症因子TNF-α[(85.74±10.39)ng/L]、SAA[(532.35±30.47)mg/L]、IL-6[(143.63±19.42)ng/L]及CRP[(90.24±15.23)mg/L]水平均明显低于对照组[(125.52±20.82)ng/L、(641.33±40.72)mg/L、(183.12±25.82)ng/L、(114.13±20.36)mg/L],差异有统计学意义。观察组治疗后IgG水平[(10.66±1.42)(g·L)^(-1)]明显高于对照组[(9.14±1.03)(g·L)^(-1)],差异有统计学意义。观察组患者治疗后,外周血T淋巴细胞亚群CD3^(+)[(58.93±10.49)%]、CD4^(+)[(36.36±4.72)%]、CD8^(+)[(25.72±4.46)%]、CD3^(+)/CD8^(+)水平[(1.46±0.32)%]均明显高于对照组[(54.03±8.17)%、(33.15±3.21)%、(20.95±3.64)%、(1.23±0.25)%],差异有统计学意。结论:肺癌患者使用外科手术结合免疫治疗可显著提升其临床康复效果,降低炎症因子水平,提升免疫力,改善预后,值得临床推广应用。

Objective To explore the effect of surgical operation combined with immunotherapy on inflammatory factors and clinical rehabilitation in patients with lung cancer,and to provide guidance for the diagnosis and treatment of patients.Methods 91 lung cancer patients admitted to The 903 hospital of Jiangyou from January 2016 to December 2018 were selected for study.All patients were divided into two groups according to the random number table.46 cases in the control group were treated only by surgery,and 45 cases in the observation group were treated by surgery combined with immunotherapy To observe the levels of inflammatory factors tumor necrosis factor alpha(TNF-α),amyloid A(SAA),interleukin-6(IL-6),C-reactive protein(CRP),immunocytokine immunoglobulin before and after treatment in the two groups.Changes in CD3^(+),CD4^(+),CD8^(+),CD3^(+)/CD8^(+)levels in protein M(IgM),immunoglobulin A(IgA),immunoglobulin G(IgG),and peripheral blood T lymphocyte subsets,the post-treatment disease control rate(DCR)and objective response rate(ORR)were compared between the two groups after treatment.Results The ORR(45.22%)and DCR(82.22%)in the observation group were significantly higher than those in the control group(21.74%,58.70%),and the difference were statistically significant.The levels of TNF-α[(85.74±10.39)ng/L],SAA[(532.35±30.47)mg/L],IL-6[(143.63±19.42)ng/L]and CRP[(90.24±15.23)mg/L]in the observation group were significantly lower than those in the control group[(125.52±20.82)ng/L,(641.33±40.72)mg/L,(183.12±25.82)ng/L,(114.13±20.36)mg/l],the difference were statistically significant.The level of IgG[(10.66±1.42)(g·L)^(-1)]in the observation group were significantly higher than that in the control group[(9.14±1.03)(g·L)^(-1)],the difference were statistically significant.After treatment in the observation group,peripheral blood T lymphocyte subsets CD3^(+)[(58.93±10.49)%],CD4^(+)[(36.36±4.72)%],CD8^(+)[(25.72±4.46)%],CD3^(+)/CD8^(+)[(1.46±0.32)%]were significantly higher than the control group[(54.03±8.17)%,(33.15±3.21)%,(20.95±3.64)%,(1.23±0.25)%],the difference were statistically significant.Conclusion Surgical combined with immunotherapy can significantly improve the clinical rehabilitation effect,reduce the level of inflammatory factors,improve immunity and improve the prognosis of patients with lung cancer.It is worthy of clinical application.