双歧杆菌三联活菌辅助XELOX方案对结直肠癌术后抗肿瘤免疫应答和肿瘤标志物的影响

Effect of Bifidobacterium triple viable bacteria capsule assisting XELOX regimen on anti-tumor immune response and tumor markers after colorectal cancer surgery

目的观察双歧杆菌三联活菌胶囊辅助草酸铂联合卡培他滨(XELOX)化疗方案对结直肠癌术后抗肿瘤免疫应答、血清癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原724(CA724)水平及毒性不良反应的影响。方法回顾性选取2017年1月至12月收治的112例结直肠癌患者作为观察对象,所有患者均接受手术治疗。以术后给予XELOX化疗方案治疗(21 d为1个化疗周期,共2个周期)的56例为对照组,以在相同化疗方案治疗基础上给予双歧杆菌三联活菌胶囊辅助治疗的56例为观察组。检测并比较反映患者抗肿瘤免疫应答情况的两组细胞免疫功能指标、血清CEA、CA199、CA724水平及毒性不良反应发生情况。结果 2个化疗周期结束后,观察组CD4^+、CD4^+/CD8^+水平高于对照组,CD8^+水平低于对照组(P均<0.05);血清CEA、CA199、CA724水平低于对照组(P均<0.05)。治疗过程中,观察组Ⅰ～Ⅱ度白细胞减少症、Ⅰ～Ⅱ度胃肠道反应和Ⅰ～Ⅱ度肝功能损害等毒性不良反应发生率低于对照组(P均<0.05),其他不良反应发生率组间比较无统计学差异(P均>0.05)。结论对于接受XELOX方案治疗的结直肠癌术后患者,双歧杆菌三联活菌胶囊辅助治疗有助于增强抗肿瘤免疫应答,降低血清CEA、CA199、CA724水平,并减少毒性不良反应的发生。

Objective To observe the influences of adjuvant therapy of bifidobacterium triple viable bacteria capsule on anti-tumor immune response,serum levels of serum carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),carbohydrate antigen 724(CA724)and toxicity and adverse reactions in colorectal cancer patients treated with oxaliplatin plus capecitabine(XELOX)chemotherapy regimen after surgery.Methods A total of 112 patients with colorectal cancer receiving surgical treatment from January to December 2017 were retrospectively selected as the observation objects,and 56 patients treated with XELOX chemotherapy regimen after operation were taken as control group,while 56 patients treated with Bifidobacterium triple viable bacteria capsule adjuvant therapy on the basis of the same chemotherapy regimen were taken as observation group.The indicators of cellular immune function,serum levels of CEA,CA199 and CA724 and the occurrence of toxic adverse reactions were observed and compared between two groups.Results After 2 cycles of chemotherapy,the levels of CD4^+,CD4^+/CD8^+increased,the level of CD8^+decreased,as well as the serum levels of CEA,CA199 and CA724 decreased in observation group compared with control group(all P<0.05).During the course of treatment,the incidences of gradeⅠ-Ⅱleucopenia,gradeⅠ-Ⅱgastrointestinal reactions and gradeⅠ-Ⅱhepatic dysfunction in observation group were statistically lower than those in control group(all P<0.05),and there were no statistical differences in the incidence of other adverse reactions between two groups(all P>0.05).Conclusion For coloreclal cancer patients receiving XELOX regimen after surgery,adjuvant therapy of Bifidobacterium triple viable bacteria capsule is helpful to enhance the anti-tumor immune response,reduce the serum CEA,CA199,CA724 levels and toxic adverse reactions.