Objective： To evaluate the efficacy and toxicity of the combination regimen of paclitaxel, cisplatin and 5-FU （PCF） as first-line or second-line therapy in patients with advanced gastric and esophagogastric juncti...Objective： To evaluate the efficacy and toxicity of the combination regimen of paclitaxel, cisplatin and 5-FU （PCF） as first-line or second-line therapy in patients with advanced gastric and esophagogastric junction （EGJ） adenocarcinoma in China. Methods： The patients were treated with paclitaxel 150 mg/m2 on dl; fractionated cisplatin 15 mg/m2 and continuous infusion 5-FU 600 mg/（mLd） intravenously on d 1-d5 of a 21-d cycle until disease progression or unacceptable toxicities. Results： Seventy-five patients have been enrolled, among which, 41 received PCF regimen as the first-line therapy （group A） and 34 received the regimen as the second-line therapy （group B） with the median age of 59 years old and Karnofsky performance status （KPS） score 〉80. Toxicities were analyzed in all 75 patients. Seventy-one patients were evaluable for efficacy. The median overall survival （mOS） was 12.0 months （95% CI： 7.9-16.2 months） in group A and 7.3 months （95% CI： 4.3-10.3 months） in group B, respectively. The median progression-free survival （mPFS） was 5.7 months （95% CI： 4.1-7.2 months） and 5.0 months （95% CI： 3.1-6.9 months）, respectively. The response rate （CR^PR） was 40% （16/40; 95% CI： 24.9-56.7%） in group A and 22.6% （7/31; 95% CI： 9.6-41.1%） in group B. Major grade 3 or 4 adverse events include neutropenia （41.3 %）, febrile neutropenia （9.3 %）, nausea/anorexia （10.7%）, and vomiting （5.3 %）. There was no treatment-related death. Conclusions： The combination chemotherapy with PCF is active and tolerable as first-line and second- line therapy in Chinese patients with advanced gastric and EGJ adenocarcinoma. The response and survival of PCF are same as those of DCF, but the tolerance is much better.展开更多
BACKGROUND Detailed information on metastatic patterns in of patients with esophageal and gastric cancer is limited.Early recognition of metastases is important to avoid futile locoregional treatments.Furthermore,know...BACKGROUND Detailed information on metastatic patterns in of patients with esophageal and gastric cancer is limited.Early recognition of metastases is important to avoid futile locoregional treatments.Furthermore,knowledge on metastatic patterns is necessary for further development of personalized treatment modalities.AIM To gain insight into the metastatic pattern of gastroesophageal cancer.METHODS A nationwide retrospective autopsy study of 3876 patients with adenocarcinoma(AC)or squamous cell carcinoma(SCC)of the esophagus or stomach between 1990 and 2017 was performed.Only patient with metastases were included for analysis.The metastatic pattern was analyzed according to the primary tumor location and histological subtype.RESULTS Metastatic disease was found in 268 esophageal and 331 gastric cancer patients.In esophageal cancer,the most common metastatic locations were liver(56%),distant lymph nodes(53%)and lung(50%).Esophageal AC showed more frequently metastases to the peritoneum and bone compared with esophageal SCC.In gastric cancer,the most common metastatic locations were distant lymph nodes(56%),liver(53%)and peritoneum(51%).Intestinal-type AC of the stomach showed metastases to the liver more frequently,whereas metastases to the bone,female reproductive organs and colorectum were observed more frequently in diffuse-type gastric AC.CONCLUSION This study showed differences in metastatic patterns of patients with esophageal and gastric cancer according to the primary tumor location and histological subtype.展开更多
Surgical resection with lymphadenectomy is the mainstay of treatment for all resectable esophagogastric junction tumors, prior to systemic generalization of the disease. This makes accurate pre-treatment staging and c...Surgical resection with lymphadenectomy is the mainstay of treatment for all resectable esophagogastric junction tumors, prior to systemic generalization of the disease. This makes accurate pre-treatment staging and classification of the tumors most demanding. A well-established and internationally accepted classification for adenocarcinomas of the esophagogastric junction （AEG） helps to choose the appropriate surgical approach and to make results from different institutions comparable. Distal esophageal adenocarcinomas （AEGⅠ） are distinguished from true cardia carcinomas （AEGⅡ） and subcardiac gastric cancers （AEGⅢ）. Substantial advancements in this surgical field during the preceding decades have clearly revealed that individualization of the surgical strategy is the key to successfully approaching these entities. In this review we discuss the surgical management of esophagogastric junction tumors with a tailored surgical strategy.展开更多
Objective: To evaluate the cost-utility of nivolumab plus chemotherapy compared with chemotherapy alone as the first-line treatment for advanced gastric, gastro-oesophageal junction, and esophageal adenocarcinoma in C...Objective: To evaluate the cost-utility of nivolumab plus chemotherapy compared with chemotherapy alone as the first-line treatment for advanced gastric, gastro-oesophageal junction, and esophageal adenocarcinoma in China. Methods: Based on CheckMate649, a partitioned survival model was carried out with a circulation cycle of 6 weeks to simulate the patient’s lifetime. Sensitivity analysis were adopted to verify the robustness of the results. Results: The results of the base-case analysis showed that both the total cost and utility of the nivolumab group were higher, and the ICUR value was CNY 267498.67/QALY, more than 3 times the GDP per capita of China in 2020. The results of deterministic sensitivity analysis indicated that the three most influential factors were the utility value of PFS state, the cost of nivolumab and the discount rate. The results of probabilistic sensitivity analysis were consistent with those of base-case analysis, proving that the results were robust. The scenario analysis illustrated that economical price of nivolumab was CNY 3652.71. Conclusions: Under the willing-to-pay threshold of three times the GDP per capita of China in 2020, compared with chemotherapy alone, nivolumab plus chemotherapy is not a cost-effective option in China.展开更多
BACKGROUND In Japan,the transhiatal approach,including lower mediastinal lymph node dissection,is widely performed for Siewert type II esophagogastric junction adenocarcinoma.This procedure is generally performed in a...BACKGROUND In Japan,the transhiatal approach,including lower mediastinal lymph node dissection,is widely performed for Siewert type II esophagogastric junction adenocarcinoma.This procedure is generally performed in a magnified view using laparoscopy or a robotic system,therefore,the microanatomy of the lower mediastinum is important.However,mediastinal microanatomy is still unclear and classification of lower mediastinal lymph nodes is not currently based on fascia or other microanatomical structures.AIM To clarify the fascia and layer structures of the lower mediastinum and classify the lower mediastinal tissue.METHODS We dissected the esophagus and surrounding organs en-bloc from seven cadavers fixed in 10%formalin.Organs and tissues were then cut at the level of the lower thoracic esophagus,embedded in paraffin,and serially sectioned.Tissue sections were stained with Hematoxylin-Eosin(all cadavers)and immunostained for the lymphatic endothelial marker D2-40(three cadavers).We observed the periesophageal fasciae and layers,and defined lymph node boundaries based on the fasciae.Lymphatic vessels around the esophagus were observed on immunostained tissue sections.RESULTS We identified two fasciae,A and B.We then classified lower mediastinal tissue into three areas,paraesophageal,paraaortic,and intermediate,using these fasciae as boundaries.Lymph nodes were found to be present and were counted in each area.The dorsal part of the intermediate area was thicker on the caudal side than on the cranial side in all cadavers.On the dorsal side,no blood vessels penetrated the fasciae in six of the seven cadavers,whereas the proper esophageal artery penetrated fascia B in one cadaver.D2-40 immunostaining showed lymphatic vessel connections between the paraesophageal and intermediate areas on the lateral and ventral sides of the esophagus,but no lymphatic connection between areas on the dorsal side of the esophagus.CONCLUSION Histological studies identified two fasciae surrounding the esophagus in the lower mediastinum and the layers separated by these fasciae were used to classify the lower mediastinal tissues.展开更多
食管-胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)在全球的发病率不断升高,因其特殊的解剖位置、独特的生物学行为被越来越多的临床工作者所重视。目前国内外虽然对AEG的发病、分型等已形成了一定共识,但在更多方面...食管-胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)在全球的发病率不断升高,因其特殊的解剖位置、独特的生物学行为被越来越多的临床工作者所重视。目前国内外虽然对AEG的发病、分型等已形成了一定共识,但在更多方面,尤其是外科治疗手段,诸如手术路径、胃的切除范围、淋巴结的清扫范围、消化道重建等方面仍存在较多争议。这些争议不仅限制了对AEG治疗的探索与发展,同时使得对AEG的规范化诊疗变得更加困难。本文结合近些年的相关文献,就目前AEG治疗的国内外相关共识与争议进行综述,以期为临床诊治提供更加合理、有效的方法。展开更多
目的:探讨并分析用阿帕替尼对接受手术治疗后的胃癌及食管胃结合部腺癌(Adenocarcinoma of esophageal-gastric junction,AEG)伴肝转移患者进行靶向治疗的效果。方法:选择白银市第一人民医院2019年9月至2020年9月期间收治的80例胃癌及AE...目的:探讨并分析用阿帕替尼对接受手术治疗后的胃癌及食管胃结合部腺癌(Adenocarcinoma of esophageal-gastric junction,AEG)伴肝转移患者进行靶向治疗的效果。方法:选择白银市第一人民医院2019年9月至2020年9月期间收治的80例胃癌及AEG伴肝转移患者(其中胃癌患者有42例,AEG伴肝转移患者有38例)作为研究对象。随机将其分为阿帕替尼组(n=40)与常规治疗组(n=40)。对两组患者均进行手术治疗及术后常规化疗,在此基础上用阿帕替尼对阿帕替尼组患者进行靶向治疗,然后比较两组患者的近期疗效及不良反应的发生率。结果:阿帕替尼组患者疾病的总缓解率高于常规治疗组患者,差异有统计学意义(P<0.05)。用药后,两组患者不良反应的发生率相比,差异无统计学意义(P>0.05)。结论:在对胃癌及AEG伴肝转移患者进行手术及术后常规化疗的基础上,用阿帕替尼对其进行靶向治疗能显著提高其近期疗效,且治疗的安全性较高。展开更多
目的 总结食管胃结合部腺癌(adenocarcinoma of the esophagogastric junction,AEG)淋巴结转移规律及清扫价值,以期有助于对不同AEG患者制定适宜的个性化淋巴结清扫策略。方法 检索近年来国内外关于AEG淋巴结转移情况及清扫价值的报道,...目的 总结食管胃结合部腺癌(adenocarcinoma of the esophagogastric junction,AEG)淋巴结转移规律及清扫价值,以期有助于对不同AEG患者制定适宜的个性化淋巴结清扫策略。方法 检索近年来国内外关于AEG淋巴结转移情况及清扫价值的报道,进行归纳总结。结果 AEG的淋巴结转移率较高的站点包括No.1、No.2、No.3、No.7组淋巴结等,淋巴结转移率较高的站点往往清扫的获益也较大。淋巴结转移与肿瘤大小、肿瘤位置等因素有关,个别站点的淋巴结清扫仍存在争议。结论 AEG的淋巴结清扫范围争议颇多,尤其是SiewertⅡ型AEG的淋巴结清扫范围,仍需要前瞻性多中心研究的证明。展开更多
目的分析新辅助化疗对食管胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)患者疗效及CD66b^(+)中性粒细胞、调节性T细胞(regulatory cell,Treg)和调节性B细胞(regulatory B cell,Breg)水平的影响。方法收集2018年1月至2...目的分析新辅助化疗对食管胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)患者疗效及CD66b^(+)中性粒细胞、调节性T细胞(regulatory cell,Treg)和调节性B细胞(regulatory B cell,Breg)水平的影响。方法收集2018年1月至2019年6月海安市人民医院经胃镜病理活检诊断的122例Ⅱ-Ⅲ期AEG手术患者为研究对象,单纯手术治疗者设为对照组(63例),联合新辅助化疗者为实验组(59例)。采用卡式功能(Karnofsky,KPS)评分评价治疗效果;免疫组织化学染色对肿瘤病灶的CD66b^(+)中性粒细胞进行计数;流式细胞仪检测Treg、Breg及CD3^(+)、CD4^(+)、CD8^(+)细胞水平,根据随访结果分析患者生存情况,采用Spearman相关性分析患者的生存状况与肿瘤组织Treg细胞、Breg细胞、CD66b^(+)中性粒细胞的相关性,统计治疗期间患者不良反应发生情况。结果经过治疗后,实验组和对照组KPS评分均升高,且实验组KPS评分高于对照组,差异具有统计学意义[分:(85.59±1.27)比(82.33±1.33),t=13.85,P<0.05)];实验组CD66b^(+)中性粒细胞计数低于对照组[109/L:(5.66±1.47)比(8.75±1.15),t=12.87,P<0.05)];实验组和对照组患者的Treg细胞和Breg细胞比例均下降,且实验组患者的Treg细胞和Breg细胞低于对照组[%:(2.05±0.21)比(3.11±0.23);(3.05±0.80)比(4.68±0.76),t值分别为26.61和11.52,P值均<0.05)];实验组肿瘤组织的CD3^(+)、CD4^(+)细胞水平高于对照组,CD8^(+)细胞低于对照组,差异均具有统计学意义[%:(0.99±0.21)比(0.78±0.12),(0.68±0.23)比(0.37±0.09),(0.44±0.04)比(0.64±0.12),t值分别为6.72、9.68和12.51,P值均<0.05)];实验组患者中位总生存期(overall survival,OS)、无进展生存期(progression-free survival,PFS)均高于对照组[月:(12.77±2.08)比(10.04±2.01),(9.62±1.24)比(7.43±1.11),t值分别为34.34、10.25,P值均<0.05)];实验组和对照组患者不良反应发生率的差异无统计学意义(P>0.05)。结论AEG患者术前采用新辅助化疗较对照组CD66b^(+)中性粒细胞、Treg细胞和Breg细胞比例降低,治疗效果良好,建议推广。展开更多
文摘Objective： To evaluate the efficacy and toxicity of the combination regimen of paclitaxel, cisplatin and 5-FU （PCF） as first-line or second-line therapy in patients with advanced gastric and esophagogastric junction （EGJ） adenocarcinoma in China. Methods： The patients were treated with paclitaxel 150 mg/m2 on dl; fractionated cisplatin 15 mg/m2 and continuous infusion 5-FU 600 mg/（mLd） intravenously on d 1-d5 of a 21-d cycle until disease progression or unacceptable toxicities. Results： Seventy-five patients have been enrolled, among which, 41 received PCF regimen as the first-line therapy （group A） and 34 received the regimen as the second-line therapy （group B） with the median age of 59 years old and Karnofsky performance status （KPS） score 〉80. Toxicities were analyzed in all 75 patients. Seventy-one patients were evaluable for efficacy. The median overall survival （mOS） was 12.0 months （95% CI： 7.9-16.2 months） in group A and 7.3 months （95% CI： 4.3-10.3 months） in group B, respectively. The median progression-free survival （mPFS） was 5.7 months （95% CI： 4.1-7.2 months） and 5.0 months （95% CI： 3.1-6.9 months）, respectively. The response rate （CR^PR） was 40% （16/40; 95% CI： 24.9-56.7%） in group A and 22.6% （7/31; 95% CI： 9.6-41.1%） in group B. Major grade 3 or 4 adverse events include neutropenia （41.3 %）, febrile neutropenia （9.3 %）, nausea/anorexia （10.7%）, and vomiting （5.3 %）. There was no treatment-related death. Conclusions： The combination chemotherapy with PCF is active and tolerable as first-line and second- line therapy in Chinese patients with advanced gastric and EGJ adenocarcinoma. The response and survival of PCF are same as those of DCF, but the tolerance is much better.
文摘BACKGROUND Detailed information on metastatic patterns in of patients with esophageal and gastric cancer is limited.Early recognition of metastases is important to avoid futile locoregional treatments.Furthermore,knowledge on metastatic patterns is necessary for further development of personalized treatment modalities.AIM To gain insight into the metastatic pattern of gastroesophageal cancer.METHODS A nationwide retrospective autopsy study of 3876 patients with adenocarcinoma(AC)or squamous cell carcinoma(SCC)of the esophagus or stomach between 1990 and 2017 was performed.Only patient with metastases were included for analysis.The metastatic pattern was analyzed according to the primary tumor location and histological subtype.RESULTS Metastatic disease was found in 268 esophageal and 331 gastric cancer patients.In esophageal cancer,the most common metastatic locations were liver(56%),distant lymph nodes(53%)and lung(50%).Esophageal AC showed more frequently metastases to the peritoneum and bone compared with esophageal SCC.In gastric cancer,the most common metastatic locations were distant lymph nodes(56%),liver(53%)and peritoneum(51%).Intestinal-type AC of the stomach showed metastases to the liver more frequently,whereas metastases to the bone,female reproductive organs and colorectum were observed more frequently in diffuse-type gastric AC.CONCLUSION This study showed differences in metastatic patterns of patients with esophageal and gastric cancer according to the primary tumor location and histological subtype.
文摘Surgical resection with lymphadenectomy is the mainstay of treatment for all resectable esophagogastric junction tumors, prior to systemic generalization of the disease. This makes accurate pre-treatment staging and classification of the tumors most demanding. A well-established and internationally accepted classification for adenocarcinomas of the esophagogastric junction （AEG） helps to choose the appropriate surgical approach and to make results from different institutions comparable. Distal esophageal adenocarcinomas （AEGⅠ） are distinguished from true cardia carcinomas （AEGⅡ） and subcardiac gastric cancers （AEGⅢ）. Substantial advancements in this surgical field during the preceding decades have clearly revealed that individualization of the surgical strategy is the key to successfully approaching these entities. In this review we discuss the surgical management of esophagogastric junction tumors with a tailored surgical strategy.
文摘Objective: To evaluate the cost-utility of nivolumab plus chemotherapy compared with chemotherapy alone as the first-line treatment for advanced gastric, gastro-oesophageal junction, and esophageal adenocarcinoma in China. Methods: Based on CheckMate649, a partitioned survival model was carried out with a circulation cycle of 6 weeks to simulate the patient’s lifetime. Sensitivity analysis were adopted to verify the robustness of the results. Results: The results of the base-case analysis showed that both the total cost and utility of the nivolumab group were higher, and the ICUR value was CNY 267498.67/QALY, more than 3 times the GDP per capita of China in 2020. The results of deterministic sensitivity analysis indicated that the three most influential factors were the utility value of PFS state, the cost of nivolumab and the discount rate. The results of probabilistic sensitivity analysis were consistent with those of base-case analysis, proving that the results were robust. The scenario analysis illustrated that economical price of nivolumab was CNY 3652.71. Conclusions: Under the willing-to-pay threshold of three times the GDP per capita of China in 2020, compared with chemotherapy alone, nivolumab plus chemotherapy is not a cost-effective option in China.
文摘BACKGROUND In Japan,the transhiatal approach,including lower mediastinal lymph node dissection,is widely performed for Siewert type II esophagogastric junction adenocarcinoma.This procedure is generally performed in a magnified view using laparoscopy or a robotic system,therefore,the microanatomy of the lower mediastinum is important.However,mediastinal microanatomy is still unclear and classification of lower mediastinal lymph nodes is not currently based on fascia or other microanatomical structures.AIM To clarify the fascia and layer structures of the lower mediastinum and classify the lower mediastinal tissue.METHODS We dissected the esophagus and surrounding organs en-bloc from seven cadavers fixed in 10%formalin.Organs and tissues were then cut at the level of the lower thoracic esophagus,embedded in paraffin,and serially sectioned.Tissue sections were stained with Hematoxylin-Eosin(all cadavers)and immunostained for the lymphatic endothelial marker D2-40(three cadavers).We observed the periesophageal fasciae and layers,and defined lymph node boundaries based on the fasciae.Lymphatic vessels around the esophagus were observed on immunostained tissue sections.RESULTS We identified two fasciae,A and B.We then classified lower mediastinal tissue into three areas,paraesophageal,paraaortic,and intermediate,using these fasciae as boundaries.Lymph nodes were found to be present and were counted in each area.The dorsal part of the intermediate area was thicker on the caudal side than on the cranial side in all cadavers.On the dorsal side,no blood vessels penetrated the fasciae in six of the seven cadavers,whereas the proper esophageal artery penetrated fascia B in one cadaver.D2-40 immunostaining showed lymphatic vessel connections between the paraesophageal and intermediate areas on the lateral and ventral sides of the esophagus,but no lymphatic connection between areas on the dorsal side of the esophagus.CONCLUSION Histological studies identified two fasciae surrounding the esophagus in the lower mediastinum and the layers separated by these fasciae were used to classify the lower mediastinal tissues.
文摘食管-胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)在全球的发病率不断升高,因其特殊的解剖位置、独特的生物学行为被越来越多的临床工作者所重视。目前国内外虽然对AEG的发病、分型等已形成了一定共识,但在更多方面,尤其是外科治疗手段,诸如手术路径、胃的切除范围、淋巴结的清扫范围、消化道重建等方面仍存在较多争议。这些争议不仅限制了对AEG治疗的探索与发展,同时使得对AEG的规范化诊疗变得更加困难。本文结合近些年的相关文献,就目前AEG治疗的国内外相关共识与争议进行综述,以期为临床诊治提供更加合理、有效的方法。
文摘目的:探讨并分析用阿帕替尼对接受手术治疗后的胃癌及食管胃结合部腺癌(Adenocarcinoma of esophageal-gastric junction,AEG)伴肝转移患者进行靶向治疗的效果。方法:选择白银市第一人民医院2019年9月至2020年9月期间收治的80例胃癌及AEG伴肝转移患者(其中胃癌患者有42例,AEG伴肝转移患者有38例)作为研究对象。随机将其分为阿帕替尼组(n=40)与常规治疗组(n=40)。对两组患者均进行手术治疗及术后常规化疗,在此基础上用阿帕替尼对阿帕替尼组患者进行靶向治疗,然后比较两组患者的近期疗效及不良反应的发生率。结果:阿帕替尼组患者疾病的总缓解率高于常规治疗组患者,差异有统计学意义(P<0.05)。用药后,两组患者不良反应的发生率相比,差异无统计学意义(P>0.05)。结论:在对胃癌及AEG伴肝转移患者进行手术及术后常规化疗的基础上,用阿帕替尼对其进行靶向治疗能显著提高其近期疗效,且治疗的安全性较高。
文摘目的 总结食管胃结合部腺癌(adenocarcinoma of the esophagogastric junction,AEG)淋巴结转移规律及清扫价值,以期有助于对不同AEG患者制定适宜的个性化淋巴结清扫策略。方法 检索近年来国内外关于AEG淋巴结转移情况及清扫价值的报道,进行归纳总结。结果 AEG的淋巴结转移率较高的站点包括No.1、No.2、No.3、No.7组淋巴结等,淋巴结转移率较高的站点往往清扫的获益也较大。淋巴结转移与肿瘤大小、肿瘤位置等因素有关,个别站点的淋巴结清扫仍存在争议。结论 AEG的淋巴结清扫范围争议颇多,尤其是SiewertⅡ型AEG的淋巴结清扫范围,仍需要前瞻性多中心研究的证明。
文摘目的分析新辅助化疗对食管胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)患者疗效及CD66b^(+)中性粒细胞、调节性T细胞(regulatory cell,Treg)和调节性B细胞(regulatory B cell,Breg)水平的影响。方法收集2018年1月至2019年6月海安市人民医院经胃镜病理活检诊断的122例Ⅱ-Ⅲ期AEG手术患者为研究对象,单纯手术治疗者设为对照组(63例),联合新辅助化疗者为实验组(59例)。采用卡式功能(Karnofsky,KPS)评分评价治疗效果;免疫组织化学染色对肿瘤病灶的CD66b^(+)中性粒细胞进行计数;流式细胞仪检测Treg、Breg及CD3^(+)、CD4^(+)、CD8^(+)细胞水平,根据随访结果分析患者生存情况,采用Spearman相关性分析患者的生存状况与肿瘤组织Treg细胞、Breg细胞、CD66b^(+)中性粒细胞的相关性,统计治疗期间患者不良反应发生情况。结果经过治疗后,实验组和对照组KPS评分均升高,且实验组KPS评分高于对照组,差异具有统计学意义[分:(85.59±1.27)比(82.33±1.33),t=13.85,P<0.05)];实验组CD66b^(+)中性粒细胞计数低于对照组[109/L:(5.66±1.47)比(8.75±1.15),t=12.87,P<0.05)];实验组和对照组患者的Treg细胞和Breg细胞比例均下降,且实验组患者的Treg细胞和Breg细胞低于对照组[%:(2.05±0.21)比(3.11±0.23);(3.05±0.80)比(4.68±0.76),t值分别为26.61和11.52,P值均<0.05)];实验组肿瘤组织的CD3^(+)、CD4^(+)细胞水平高于对照组,CD8^(+)细胞低于对照组,差异均具有统计学意义[%:(0.99±0.21)比(0.78±0.12),(0.68±0.23)比(0.37±0.09),(0.44±0.04)比(0.64±0.12),t值分别为6.72、9.68和12.51,P值均<0.05)];实验组患者中位总生存期(overall survival,OS)、无进展生存期(progression-free survival,PFS)均高于对照组[月:(12.77±2.08)比(10.04±2.01),(9.62±1.24)比(7.43±1.11),t值分别为34.34、10.25,P值均<0.05)];实验组和对照组患者不良反应发生率的差异无统计学意义(P>0.05)。结论AEG患者术前采用新辅助化疗较对照组CD66b^(+)中性粒细胞、Treg细胞和Breg细胞比例降低,治疗效果良好,建议推广。
