CT引导下射频消融联合靶向治疗对中晚期非小细胞肺癌患者免疫功能的影响

Influence of radiofrequency ablation guided by CT combined with targeted therapy on immune function of patients with advanced non small cell lung cancer

目的探讨CT引导下射频消融联合靶向治疗对中晚期非小细胞肺癌患者免疫功能的影响。方法选择2012年10月~2014年10月陕西省人民医院中晚期非小细胞肺癌患者110例,采用随机数字表法分为两组,各55例。对照组实施靶向治疗,观察组实施CT引导下射频消融联合靶向治疗。于治疗前后行免疫学指标(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、NK细胞、Ig G、Ig M、Ig A)检测,采用QLQ-C30评价生活质量(心理功能、躯体功能、角色功能、认知功能、社会功能),比较两组临床疗效及不良反应。结果两组治疗前免疫学指标及生活质量评分差异均无统计学意义(均P>0.05);同组治疗前后比较,CD3^+、CD4^+、CD4^+/CD8^+、NK细胞、Ig G、Ig M、Ig A水平降低,CD8^+水平升高,生活质量评分增加,差异有统计学意义(P<0.05);两组治疗后比较,观察组CD3^+、CD4^+、CD4^+/CD8^+、NK细胞、Ig G、Ig M、Ig A水平及生活质量评分高于对照组(P<0.05),CD8^+水平低于对照组(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论 CT引导下射频消融联合靶向治疗可在一定程度上减轻中晚期非小细胞肺癌患者的免疫功能损伤,并提高其生活质量,疗效显著且安全性高。

Objective To investigate the influence of radiofrequency ablation guided by CT combined with targeted therapy on immune function of patients with advanced non small cell lung cancer. Methods 110 patients with advanced non small cell lung cancer in Shaanxi Provincial People’s Hospital from October 2012 to October 2014 were selected and divided into two groups by random number table method, each group had 55 cases. Patients in the control group received targeted therapy, while patients in the observation group received radiofrequency ablation guided by CT and targeted therapy. Immunological indexes(CD3^+, CD4^+, CD8^+, CD4^+/CD8^+, NK cell, Ig G, Ig M, Ig A) were detected before and after treatment. Quality of life(mental function, physical function, role function, cognitive function, social function)was evaluated by QLQ-C30. Clinical efficacy and adverse reactions were compared between the two groups. Results Compared between two groups before treatment, the immunological indexes and scores of life quality had no significant differences(P > 0.05). In the same group, compared with before treatment, after treatment levels of CD3^+, CD4^+, CD4^+/CD8^+, NK cell, Ig G, Ig M, Ig A decreased, while CD8^+level increased, and scores of life quality improved(P < 0.05). After treatment compared with the control group, in the observation group levels of CD3^+, CD4^+, CD4^+/CD8^+, NK cell, Ig G,Ig M, Ig A and scores of life quality increased, while CD8^+level decreased, with statistically significant differences(P < 0.05).The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). There was no significant difference in adverse reaction between the two groups(P > 0.05). Conclusion Radiofrequency ablation guided by CT combined with targeted therapy can reduce immune function injury of patients with advanced non small cell lung cancer in a certain degree, and improve quality of life, which has significant efficacy and high safety.