低温等离子消融联合顺铂治疗喉癌的疗效观察

Efficacy of low-temperature plasma ablation combined with cisplatin for laryngeal cancer

目的探讨低温等离子消融联合顺铂对喉癌患者免疫球蛋白、血清血管内皮生长因子C(VEGF-C)、磷酸酶基因(PTEN)水平及复发的影响。方法选取2018年2月至2020年6月间营口市中心医院行低温等离子消融术的60例喉癌患者。根据治疗方式不同分为对照组和观察组。采用消融术治疗的34例患者纳入对照组,采用消融术联合顺铂治疗的26例患者纳入观察组。比较两组患者术前(T0)、术后1个月(T1)、术后2个月(T2)及术后3个月(T3)的卡氏(KPS)评分、免疫球蛋白(IgG、IgM和IgA)、VEGF-C和PTEN水平,并对比复发率。结果两组患者临床效果比较,两组患者T3时点KPS评分高于T0时点,但观察组T2、T3时点KPS评分均高于对照组,差异均有统计学意义(P<0.05)。两组患者复发率比较,差异无统计学意义(P>0.05)。两组患者血清生化指标比较,术后7d免疫球蛋白IgG、IgM和IgA水平同术前比较,差异无统计学意义(P>0.05)。且两组患者术前、术后7d免疫球蛋白水平比较,差异无统计学意义(P>0.05)。但两组患者血清VEGF-C、PTEN水平均下降;术后7d观察组血清VEGF-C、PTEN水平均低于对照组,差异均有统计学意义(P<0.05)。结论低温等离子消融联合顺铂治疗喉癌,并不会影响患者免疫功能,且可降低VEGF-C、PTEN等转移相关因子水平,并提升临床治疗效果。

Objective To investigate the efficacy of low-temperature plasma ablation combined with cisplatin on the levels of immunoglobulin, serum vascular endothelial growth factor C(VEGF-C), phosphatase and tensin homolog(PTEN) and recurrence in patients with laryngeal cancer. Methods Sixty patients with laryngeal cancer were selected at Yingkou Central Hospital between February 2018 and June 2020. They were divided into an observation group and a control group based on different therapies they received. Twenty-six patients who underwent ablation and received cisplatin were included in an observation group and 34 patients who underwent ablation were included in a control group. Karnofsky performance status(KPS) score, immunoglobulin(IgG, IgM and IgA), serum VEGF-C and PTEN levels were compared between the two groups before the surgery(T0) and at 1 month(T1), 2 months(T2) and 3 months(T3) after the surgery. Results Comparison of clinical efficacy showed that the KPS score at T3 was significantly higher than that at T0(P<0.05). KPS score at T2 and T3 was significantly higher in the observation group than in the control group(all P<0.05). There was no significant difference in recurrence rate between the two groups(P>0.05). In addition, comparison of serum biochemical indicators showed that there was no significant difference in immunoglobulin IgG, IgM and IgA levels between the two groups at 7 d after the surgery(P>0.05), and there was no significant difference in immunoglobulin levels in the two groups at 7 d after the surgery compared with before the surgery(P>0.05). However, serum VEGF-C and PTEN levels were significantly decreased in both groups(all P<0.05). Serum VEGF-C and PTEN levels were significantly lower in the observation group than those in the control group at 7 d after the operation(all P<0.05). Conclusion Low-temperature plasma ablation combined with cisplatin in the treatment of laryngeal cancer will not affect the immune function, and it reduces VEGF-C, PTEN and other metastasis related factors, and improve the clinical treatment effect.