Effect of endoscopic chemo-seed implantation combined with DC-CIK therapy on tumor malignancy in patients with obstructive esophageal cancer

Objective:To study the effect of endoscopic chemo-seed implantation combined with DC-CIK therapy on tumor malignancy in patients with obstructive esophageal cancer.Methods: Patients with advanced obstructive esophageal cancer who were treated in Wuhan Hankou Hospital between April 2014 and November 2017 were selected and randomly divided into two groups, the experimental group received endoscopic chemo-seed implantation combined with DC-CIK therapy and the control group received endoscopic chemo-seed implantation. The contents of serum tumor markers and peripheral blood immune cells were determined before treatment and 4 weeks after treatment;the expression levels of tumor suppressor genes in esophageal cancer lesions were measured 4 weeks after treatment.Results:CA199, SCCAg and CYFRA21-1 contents in serum of both groups after treatment were lower than those before treatment;Th1 content in peripheral blood of experimental group after treatment was higher than that before treatment whereas Th2, Treg and Th17 contents were lower than those before treatment;Th1, Th2, Treg and Th17 contents in peripheral blood of control group after treatment were not significantly different from those before treatment, and CA199, SCCAg and CYFRA21-1 contents in serum as well as Th2, Treg and Th17 contents in peripheral blood of experimental group after treatment were lower than those of control group whereas Th1 content in peripheral blood as well as ECRG4, Beclin1, PTEN and Spink8 mRNA expression was higher than those of control group.Conclusion: Endoscopic chemo-seed implantation combined with DC-CIK therapy can be more effective than seed implantation alone to reduce the tumor malignancy of obstructive esophageal cancer.

梗阻性食管癌患者接受内镜下化疗粒子植入联合DC-CIK治疗后的肿瘤恶性程度评估

目的:研究内镜下化疗粒子植入联合DC-CIK治疗对梗阻性食管癌患者肿瘤恶性程度的影响。方法:选择武汉市汉口医院2014年4月~2017年11月期间收治的晚期梗阻性食管癌患者,随机分入两组,实验组接受内镜下化疗粒子植入联合DC-CIK治疗、对照组接受内镜下化疗粒子植入治疗。治疗前及治疗后4周时,测定血清中肿瘤标志分子及外周血中免疫细胞的含量;治疗后4周时,测定食管癌病灶内抑癌基因的表达量。结果:两组患者治疗后血清中CA199、SCCAg、CYFRA21-1的含量均低于治疗前;实验组患者治疗后外周血中Th1的含量高于治疗前,Th2、Treg、Th17的含量低于治疗前;对照组患者治疗后外周血中Th1、Th2、Treg、Th17的含量与治疗前比较无显著性差异,且实验组患者治疗后血清中CA199、SCCAg、CYFRA21-1的含量以及外周血中Th2、Treg、Th17的含量均低于对照组,外周血中Th1的含量以及食管癌病灶内ECRG4、Beclin1、PTEN、Spink8的mRNA表达量均高于对照组。结论:内镜下化疗粒子植入联合DC-CIK治疗能够较单纯粒子植入治疗更为有效地降低梗阻性食管癌的肿瘤恶性程度。

多靶动脉减量灌注化疗联合^(125)I放射性粒子植入治疗ⅢB期非小细胞肺癌的临床意义

目的比较研究^(125)I放射性粒子植入联合多靶动脉减量灌注化疗治疗ⅢB期非小细胞肺癌(NSCLC)与联合静脉化疗临床疗效的差异。方法选取在2013年7月至2018年12月接受局部^(125)I放射性植入治疗联合化疗的ⅢB期NSCLC患者作为研究对象,收集患者各项临床特征资料,包括性别、年龄、体力状况、吸烟指数、病理类型、化疗方式、肿瘤体积(gross tumor volume,GTV)和100%靶区所受剂量(D100)等,接受动脉灌注化疗的患者为MAC组,接受静脉化疗的患者为SVC组。随访并行短期疗效评价和记录生存时间。结果57例SVC组CR、PR、SD和PR患者分别为1.8%(1/57)、47.4%(27/57)、45.6%(26/57)和5.3%(3/57),OR为49.1%;19例MAC组患者CR、PR、SD和PR分别为15.8%(3/19)、52.6%(10/19)、21.1%(4/19)和10.5%(2/19),OR为68.4%;两组差异有统计学意义(χ^(2)=8.192,P=0.042)。SVC组患者1、2和3年生存率分别为73.7%、26.3%和8.8%,mOS为16.3个月;MAC组患者1、2和3年生存率为84.2%、42.1%和15.8%,mOS为20.0个月;两组差异有统计学意义(χ^(2)=3.916,P=0.048)。亚组分析显示单一支气管动脉供血的患者mOS为25.0个月,多靶动脉供血患者mOS为16.8个月,两组患者OS差异明显(χ^(2)=3.944,P=0.047)。应用Cox模型单因素分析显示:GTV(HR=3.090,95%CI:1.057-8.884,P=0.036)、D100(HR=4.463,95%CI:1.261-15.798,P=0.020)、供血动脉(HR=5.885,95%CI:1.877-18.449,P=0.002)与OS显著相关,多因素分析显示:多靶动脉供血是影响OS的独立危险因素(HR=4.776,95%CI:1.265-18.039,P=0.021)。结论^(125)I放射性粒子植入治疗联合多靶动脉减量灌注化疗治疗ⅢB期NSCLC在局部病灶控制、延长生存时间方面优于联合静脉化疗,可作为治疗手段之一进行临床推广。

CT引导下^(125)I粒子植入联合化疗治疗非小细胞肺癌的疗效分析

目的探讨CT引导下^(125)I粒子植入联合化疗治疗不可切除的非小细胞肺癌的价值。方法回顾性分析2012年1月至2016年12月该院治疗的42例中晚期非小细胞肺癌患者相关资料。^(125)I粒子植入联合化疗(23例)为A组,单纯化疗(19例)为B组。所有患者治疗后第1、2、6个月复查胸部CT,对比两组治疗效果和并发症发生情况。结果两组患者治疗后第1、2、6个月总体有效率(RR)比较,差异均有统计学意义(P<0.05)。A组患者不良反应为气胸26.1%(6/23),骨髓抑制26.1%(6/23),恶心、呕吐30.4%(7/23);B组患者不良反应为骨髓抑制36.8%(7/19),恶心、呕吐26.3%(5/19)。两组均未见严重并发症,对症处理后好转,不良反应发生率比较差异无统计学意义(P>0.05)。结论 CT引导下^(125)I粒子植入联合化疗治疗不可切除的非小细胞肺癌较单纯化疗治疗的有效率更高,疗效更明显。