摘要
目的探讨手术联合OPEC方案化疗对神经母细胞瘤(NB)患儿免疫功能及预后的影响。方法收集2016年1月—2018年12月本院收治的80例NB患儿资料,依据是否行手术治疗分为观察组(41例)和对照组(39例)。对照组仅接受OPEC方案(长春新碱+顺铂+依托泊苷+环磷酰胺)化疗;观察组在接受OPEC方案化疗后行手术治疗,两组均化疗6个疗程。检测两组患儿治疗前后细胞免疫指标(TTL、THL、TSL、CD4^+/CD8^+、NK细胞)和体液免疫指标(免疫球蛋白IgA、IgG、IgE、IgM)的水平。观察两组治疗期间的药物不良反应,并进行随访,统计患儿死亡情况。结果治疗后,两组患儿的TTL、CD4^+/CD8^+水平明显下降,THL、TSL、NK细胞水平明显上升,差异均有统计学意义(P<0.05),且观察组TTL、THL、CD4^+/CD8^+、NK细胞水平明显高于对照组,TSL水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患儿IgA、IgG、IgE、IgM水平明显下降,且观察组显著低于对照组,差异有统计学意义(P<0.05)。观察组患儿1年、2年生存率分别为80.00%、53.33%,对照组分别为63.64%、45.46%,经Log-rank检验,两组患儿的生存率比较,差异无统计学意义(P>0.05)。结论手术联合OPEC方案化疗可减轻OPEC方案单独化疗对NB患儿免疫功能下降的影响,且不增加预后不良的风险,对于NB的治疗具有积极意义。
Objective To explore the effects of surgery combined with OPEC chemotherapy on immune function and prognosis of children with neuroblastoma(NB).Methods The data of 80 NB children who were admitted to the hospital between January 2016 and December 2018 were collected.Patients who were given only OPEC chemotherapy(vincristine+cisplatin+etoposide+cyclophosphamide)were taken as control group(n=39),and those who underwent surgical treatment after OPEC chemotherapy were taken as observation group(n=41).Both groups were given chemotherapy for six courses.The levels of cellular immune indexes(TTL,THL,TSL,CD4^+/CD8^+,NK cells)and humoral immune indexes(immunoglobulin IgA,IgG,IgE,IgM)were detected in both groups before and after treatment.The adverse drug reactions during treatment were observed in both groups.All patients were followed-up.The death was statistically analyzed.Results After treatment,the levels of TTL and CD4^+/CD8^+were significantly decreased in both groups,while the levels of THL,TSL and NK cells were significantly increased(P<0.05).In addition,the levels of TTL,THL and NK cells and CD4^+/CD8^+in observation group were significantly higher than those in control group,while the TSL level was significantly lower than that in control group(P<0.05).In humoral immunity,the levels of IgA,IgG,IgE and IgM in both groups were significantly decreased after treatment,and they were even lower in observation group than in control group(P<0.05).The 1-year and 2-year survival rates were respectively 80.00%and 53.33%in observation group,but were 63.64%and 45.46%respectively in control group.Log-rank test showed that there was no significant difference in survival rate between the two groups(P>0.05).Conclusion Surgery combined with OPEC chemotherapy can reduce the impact of OPEC chemotherapy alone on the immunity function of NB children without increasing the risk of poor prognosis.It is of important and positive significance for NB treatment.
作者
周宇翔
唐湘莲
黄召
肖雅玲
ZHOU Yuxiang;TANG Xianglian;HUANG Zhao;XIAO Yaling(The Second General Surgery Department,Hunan Children’s Hospital,Changsha,Hunan,410007,China)
出处
《肿瘤药学》
CAS
2020年第5期564-567,573,共5页
Anti-Tumor Pharmacy
基金
国家自然科学基金资助项目(81272986)。
