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目的:分析术前放化疗对中晚期食管癌围手术期免疫功能的影响。方法:选取广西医科大学附属肿瘤医院2008年1月至2011年1月收治138例患者,按照治疗方法分成2组,NCRT组予以放化疗联合手术,S组予以单纯手术组。分析两组有效率、治疗前、后及手术后免疫功能变化。结果:NCRT组CD4+/CD8+及NK细胞,放化疗后均显著降低(P<0.05);术后7日,均较放化疗后显著提高(P<0.05),但总体较放化疗前显著降低(P<0.05)。两组术后7日CD4+/CD8+无显著差异,且均显著低于放化疗/术前(P<0.05);术后7日NCRT组NK细胞显著高于S组(P<0.05)。NCRT组中有效组在放化疗后,NK细胞均较前显著增高(P<0.05),CD4+/CD8+无明显改变(P>0.05)。而无效组在放化疗后,NK细胞和CD4+/CD8+均较前显著降低(P<0.05)。结论:NCRT联合手术对中晚期食管癌免疫功能有一定抑制作用,对NCRT敏感者免疫功能影响不大,却能显著降低不敏感者免疫功能。
Objective: To analyze the effect of preoperative radiotherapy and chemotherapy on perioperative immune function in advanced esophageal cancer. Methods: Totally 138 patients were enrolled in the Affiliated Tumor Hospital of Guangxi Medical University from January 2008 to January 2011. The patients were divided into two groups according to the treatment. The patients in the NCRT group received radiotherapy and chemotherapy combined with surgery. The patients in the S group were treated with surgery alone. Analysis of two groups of effective, before and after treatment and immune function changes. Results: The numbers of CD4 + / CD8 + and NK cells in NCRT group were significantly decreased after radiotherapy and chemotherapy (all P <0.05), and were significantly higher than those in radiotherapy and chemotherapy group on the 7th day after operation (P <0.05) P <0.05). There was no significant difference of CD4 + / CD8 + on the 7th postoperative day between the two groups, which were significantly lower than those before radiotherapy / chemotherapy (P <0.05). NK cells in NCRT group were significantly higher than those in S group on the 7th day after operation (P <0.05). In the NCRT group, NK cells in the effective group were significantly increased (P <0.05) and CD4 + / CD8 + did not change significantly after radiochemotherapy (P> 0.05). However, in NK group and CD4 + / CD8 + group, the number of NK cells and CD4 + / CD8 + decreased significantly after radiotherapy and chemotherapy (P <0.05). Conclusion: NCRT combined with surgery can inhibit the immune function of esophageal cancer in the late stage, and has little effect on the immune function of NCRT-sensitive patients, but can significantly reduce the immune function of the non-sensitive patients.