高强度聚焦超声联合TP方案治疗宫颈癌晚期临床观察及对免疫系统激活效应研究

Clinical observation of high-intensity focused ultrasound combined with TP protocol in the treatment of advanced cervical cancer and study of the effect on immune system activation

目的探讨高强度聚焦超声(HIFU)联合顺铂+紫杉醇(TP)方案治疗宫颈癌晚期临床效果及对免疫系统的激活效应。方法随机数字表法将2019年12月至2020年12月承德市中医院收治的86例宫颈癌晚期病人均分为TP组、联合组,各43例。两组均给予后装腔内放疗和体外调强放疗,在此基础上TP组给予TP方案化疗,联合组给予HIFU联合TP化疗。比较两组总有效率、血清癌胚抗原(CEA)、细胞角蛋白19片段抗原(CYFRA21-1)、糖类抗原125(CA125)、鳞状上皮细胞癌抗原(SCC-Ag)、恶性肿瘤特异生长因子(TSGF)、T淋巴细胞亚群、辅助性T淋巴细胞(Th)1/Th2、Th17/调节性T细胞(Treg)、不良反应及1年生存曲线。结果联合组总有效率为90.70%,高于TP组69.77%(P<0.05);联合组治疗后CEA、CYFRA21-1、CA125、SCC-Ag、TS-GF低于TP组(P<0.05);联合组治疗后CD3^(+)T细胞、CD4^(+)T细胞、CD4^(+)/CD8^(+)高于TP组(P<0.05);联合组治疗后Th1高于TP组,Th17、Treg低于TP组(P<0.05);联合组不良反应发生率与TP组比较,差异无统计学意义(P>0.05);联合组1年生存率为95.35%高于TP组1年生存率81.40%(P<0.05)。结论HIFU联合TP方案治疗宫颈癌晚期,可增强疗效,改善病人T淋巴细胞、辅助性T细胞及调节性T细胞免疫功能,安全可靠,并能增加病人短期生存获益。

Objective To investigate the clinical effects of high-intensity focused ultrasound(HIFU)combined with cisplatin+paclitaxel(TP)regimen in the treatment of advanced cervical cancer and the activation effect on the immune system.Methods Eighty-six patients with advanced cervical cancer admitted to Chengde Hospital of Traditional Chinese Medicine from December 2019 to December 2020 were selected and assigned into TP group and combination group according to random number table method,and 43 cases in each group.Both groups were given post-mounted intracavitary radiotherapy and extracorporeal intensity-modulated radiotherapy,based on which the TP group was given TP regimen chemotherapy and the combination group was given HIFU combined with TP chemotherapy.The total effective rate,serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen(CYFRA21-1),glycoconjugate antigen 125(CA125),squamous epithelial cell carcinoma antigen(SCC-Ag),malignancy-specific growth factor(TSGF),T lymphocyte subsets,helper T lymphocytes(Th)1/Th2,Th17/regulatory T cells(Treg),adverse effects and 1-year survival curve of the two groups were compared.Results The total effective rate of the combined group was 90.70%,which was higher than that of the TP group 69.77%(P<0.05);CEA,CYFRA21-1,CA125,SCC-Ag,and TSGF in the combined group were lower than those in the TP group after treatment(P<0.05);CD3^(+)T cells,CD4+T cells,CD4^(+)/CD8^(+)in the combined group were higher than those in the TP group after treatment(P<0.05);Th1in the combined group was higher than that in the TP group after treatment,and Th17 and Treg were lower than those in the TP group after treatment(P<0.05);there was no statistically significant difference in the incidence of adverse reactions between the combined group and the TP group(P>0.05);the 1-year survival rate of the combined group was 95.35%,which was higher than that of the TP group(81.40%)(P<0.05).Conclusion HIFU combined with TP regimen for advanced cervical cancer can enhance the efficacy,improve the immune function of T lymphocytes,helper T cells and regulatory T cells in patients,which is safe and reliable,and can increase the short-term survival benefit of patients.