摘要
目的探讨DOS辅助化疗对进展期胃癌患者术后免疫功能的影响。方法选取2016年1月~2017年10月我院收治的71例进展期胃癌患者的临床资料进行回顾性分析。按照治疗方式的不同分为研究组(n=36)和对照组(n=35)。对照组患者直接进行开腹胃癌根治术治疗。研究组患者在手术前给予DOS辅助化疗治疗,治疗3个化疗周期后休息4周,然后进行手术治疗。对比两组的疗效。记录两组的手术情况,包括手术时间、术中失血量、淋巴结清扫数目、R0手术切除情况。检测两组的免疫功能指标(CD3~+、CD4~+、CD4~+/CD8~+、NK细胞)的水平。结果两组的缓解率比较,差异无统计学意义(P>0.05);观察组的总有效率比对照组高,差异有统计学意义(P<0.05);两组治疗后的CD3~+、CD4~+、CD4~+/CD8~+、NK细胞显著降低(P<0.05);观察组治疗后的CD3~+、CD4~+、CD4~+/CD8~+、NK细胞比对照组高,差异有统计学意义(P<0.05);两组的手术时间、术中失血量、淋巴结清扫数目无明显差异,差异无统计学意义(P>0.05);观察组的R0切除率比对照组高,差异有统计学意义(P<0.05)。结论 DOS辅助化疗能提高进展期胃癌的临床疗效,改善患者免疫功能,降低肿瘤标志物水平。
Objective To investigate the effect of DOS adjuvant chemotherapy on postoperative immunologic function in patients with advanced gastric cancer. Methods Clinical data of 71 patients with advanced gastric cancer admitted to our hospital from January 2016 to October 2017 were analyzed. According to the different treatment approaches, patients were divided into experiment group(n=36) and control group(n=35). Patients in control group were treated with radical gastrectomy for gastric cancer. Patients in experiment group had been treated with three rounds of DOS adjuvant chemotherapy followed by a 4-week break before surgery. Two groups were compared in surgery outcomes, including operation time, blood loss during surgery, number of dissected lymph nodes, and R0 resection state. Indicators for immunologic function(CD3~+, CD4~+, CD4~+/CD8~+, and NK cells) were measured in both groups. Results There was no significant difference in the remission rate between the two groups(P>0.05). CD3~+, CD4~+, CD4~+/CD8~+, and NK cells for both groups were significantly lower after treatment(P<0.05), but CD3~+, CD4~+, CD4~+/CD8~+were significantly higher for exper iment group than control group(P<0.05); No significant difference was observed between two groups in operation time,blood loss and numbers of dissected lymph nodes(P>0.05).R0 resection rate for experiment group was higher than that of control group, and the difference was statistically significant(P<0.05). Conclusion DOS adjuvant chemotherapy can improve clinical efficacy of treatment for advanced gastric cancer, enable better immunologic function and lower levels of tumor markers.
引文
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