摘要
目的探讨替吉奥辅助化疗对行胰头十二指肠切除术的老年胰腺癌患者术后免疫功能及预后的影响。方法选取收治的老年胰腺癌患者79例,均行胰头十二指肠切除术治疗,将患者随机分为对照组(n=39)及观察组(n=40),对照组患者采用吉西他滨辅助化疗,观察组患者在对照组的基础上联合替吉奥辅助化疗。检测化疗前后两组肿瘤标志分子水平、免疫球蛋白含量、T淋巴细胞亚群及NK细胞比例;统计两组近远期临床疗效及治疗期间不良反应。结果与化疗前比较,化疗后两组血清CA19-9、CA50、CA125及CA242水平明显降低(P<0.01),且观察组显著低于对照组(P<0.05或P<0.01);与化疗前比较,化疗后两组血浆IgG、IgA及IgM含量均明显升高,且观察组显著高于对照组(P<0.05或P<0.01);与化疗前比较,化疗后两组CD4^+、CD8^+比例及NK细胞比例均显著降低,但观察组CD4^+比例及NK细胞比例显著高于对照组,CD8^+比例显著低于对照组(P<0.05或P<0.01);化疗前后对照组CD4^+/CD8^+比值无显著变化,而观察组化疗后CD4^+/CD8^+比值明显增加,且显著高于对照组(P<0.01)。观察组总有效率为82.50%,显著高于对照组的58.97%(P<0.05),且观察组术后1年、2年生存率也显著高于对照组(P<0.01)。两组均无严重不良反应。结论替吉奥辅助化疗可显著降低行胰头十二指肠切除术的老年胰腺癌患者术后血清肿瘤标志分子水平,保护其免疫功能,提高患者临床疗效及远期生存率,并具有一定的安全性。
Objective To explore the S-1 adjuvant chemotherapy on the postoperative immune function and the prognosis of elderly pancreatic cancer patients after pancreatoduodenectomy. Methods A total of 79 cases elderly pancreatic cancer patients were selected and all treated with pancreatoduodenectomy,all patients were divided randomly into the control group（ n =39） and the observation group（ n = 40）,the control group was treated with gemcitabine adjuvant chemotherapy,the observation group was treated with S-1 on the basis of control group. The tumor marker levels,immune globulin content,T lymphocyte subpopulation and NK cell proportion were detected before and after chemotherapy;the recent and long-term clinical efficacy and the untoward effect during treatment in the 2 groups were statisticsed. Results Compared with before chemotherapy,the serum CA19-9,CA50,CA125 and CA242 levels in the 2 groups after chemotherapy decreased significantly（ P〈0. 01）,and observation group was lower than the control group（ P〈0. 05 or P〈0. 01）;Compared with before chemotherapy,the plasma IgG,IgA and IgM content after chemotherapy in 2 groups increased significantly,and observation group was higher than control group（ P〈0. 05 or P〈0. 01）;Compared with before chemotherapy,the CD4~＋,CD8~＋ proportion and NK cell proportion decreased significantly,but the CD4~＋ proportion and NK cell proportion in the observation group was higher than that of the control group,the CD8~＋ proportion in the observation group was lower than that of the control group（ P〈0. 05 or P〈0. 01）;The CD4~＋/CD8~＋ ratio had no significant changes before and after chemotherapy,while the CD4~＋/CD8~＋ ratio after chemotherapy in the observation group increased significantly,and which was higher than that of the control group（ P〈0. 01）. The total effective rate of the observation group was 82. 50%,which was higher than that 58. 97% of the control group（ P〈0. 05）,and the 1-and 2-year survival rate of the observation grou
作者
杨更光
徐世国
YANG Gengguang;XU Shiguo(Zhengzhou No.7 People＇s Hospital,Zhengzhou,45004)
出处
《实用癌症杂志》
2018年第5期790-793,共4页
The Practical Journal of Cancer
