摘要
目的观察局部中晚期食管癌患者行新辅助化疗+食管癌根治术+术后化疗前后程序性死亡因子(programmed death factor,PD)-1、PD-2、转化生长因子-β(transforming growth factor,TGF-β)水平变化,探讨治疗效果和安全性。方法局部中晚期食管癌患者160例,依据治疗方式分为观察组和对照组各80例。对照组行食管癌根治术,术后给予顺铂+5-氟尿嘧啶化疗至少4个周期;观察组术前应用紫杉醇+顺铂方案行新辅助化疗2个周期,化疗结束后4周行食管癌根治术,手术方式及术后化疗方案同对照组。比较2组病理类型、肿瘤部位、肿瘤直径、临床分期、淋巴结转移率、R切除率及术后并发症发生情况;比较2组术后化疗情况;比较2组入院次日及术后2个月血清PD-1、PD-2、TGF-β水平;随访记录2组术后5年无病生存率和总生存率。结果观察组R切除率(86.25%)高于对照组(67.25%)(χ^(2)=3.935,P=0.048),年龄、男性比率、体质量指数、肿瘤部位、肿瘤直径、临床分期、病理类型、淋巴结转移率、病理分级及术后吻合口漏、出血、感染发生率与对照组比较差异均无统计学意义(P>0.05)。2组术后均至少完成4个周期化疗,观察组腹泻呕吐、骨髓抑制、皮疹、肝功能异常等化疗不良反应发生率与对照组比较差异均无统计学意义(P>0.05)。观察组入院次日血清PD-1[(118.6±33.2)ng/L]、PD-2[(85.2±21.6)ng/L]、TGF-β[(76.8±20.8)mg/L]水平与对照组[(112.4±32.8)ng/L、(83.5±23.4)ng/L、(75.4±21.2)mg/L]比较差异均无统计学意义(P>0.05);观察组、对照组术后2个月血清PD-1[(34.2±12.3)、(52.1±17.2)ng/L]、PD-2[(26.4±10.2)、(42.1±16.5)ng/L]、TGF-β[(20.4±11.2)、(38.2±13.4)mg/L]水平均低于入院次日(P<0.05),且观察组低于对照组(P<0.05)。观察组术后5年无病生存率(37.50%)、总生存率(71.25%)均高于对照组(18.75%、45.00%)(χ^(2)=3.789,P=0.046;χ^(2)=4.235,P=0.041)。结论局部中晚期食管癌患者食管
Objective To observe the changes of programmed death factor(PD)-1,PD-2and transforming growth factor-β(TGF-β)in patients with advanced local esophageal cancer before and after neoadjuvant chemotherapy combined with radical esophagectomy and postoperative chemotherapy,and to explore the clinical efficacy and safety.Methods Totally 160patients with advanced local esophageal cancer were divided into observation group and control group,with 80patients in each group.Control group received radical esophagectomy,and postoperative chemotherapy with cisplatin+5-fluorouracilfor at least 4cycles.Observation group received neoadjuvant chemotherapy with paclitaxel+cisplatin for 2cycles and radical esophagectomy 4 weeks after chemotherapy,with the same operation method and chemotherapy protocol as control group.The pathological type,tumor location,tumor diameter,clinical stage,lymph node metastasis rate,Rresection rate,postoperative complications and postoperative chemotherapy were compared between two groups.The levels of serum PD-1,PD-2and TGF-β were compared between two groups on the second day after admission and 2months after operation.The 5-year disease-free survival rate and overall survival rate were recorded.Results The Rresection rate was higher in observation group(86.25%)than that in control group(67.25%)(χ^(2)=3.935,P=0.048),and there were no significant differences in the age,male ratio,body mass index,tumor location,tumor diameter,clinical stage,pathological type,lymph node metastasis rate,pathological grade,and the incidences of postoperative anastomotic leakage,bleeding and infection between two groups(P>0.05).Both two groups completed at least 4cycles of postoperative chemotherapy,and there were no significant differences in the incidences of chemotherapy-related adverse reactions as diarrhea,vomiting,bone marrow suppression,rash and abnormal liver function between two groups(P>0.05).There were no significant differences in the levels of serum PD-1,PD-2and TGF-βon the second day after admission between o
作者
陈婷
崔浩波
罗洞波
初建虎
CHEN Ting;CUI Hao-bo;LUO Dong-bo;CHU Jian-hu(Department of Head and Neck Comprehensive Radiotherapy,Cancer Hospital Affiliated to Xinjiang Medical University,Urumqi,Xinjiang Uygur Autonomous Region 830011,China;Department of Thoracic Surgery,Cancer Hospital Affiliated to Xinjiang Medical University,Urumqi,Xinjiang Uygur Autonomous Region 830011,China)
出处
《中华实用诊断与治疗杂志》
2022年第7期658-661,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2020-13)。
