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目的探讨前哨淋巴结(SLN)-T淋巴细胞免疫疗法治疗伴有远处转移灶不可切除的IV期结直肠癌的临床疗效。方法将2011年11月-2016年6月来本院治疗的25例Ⅳ期伴有远处转移灶不可切除的结直肠癌患者,分为治疗组(9例)和对照组(16例),观察随访其生存情况。采用SPSS 17.0软件进行统计学分析;采用Kaplan-Meier法对病例资料进行生存分析;Log-rank检验生存曲线;COX比例风险模型多因素分析可能影响预后的因素。观察患者的基本临床特征、总生存期(overall survival,OS)。结果通过SLN-T淋巴细胞治疗伴有远处转移灶不可切除的结直肠癌患者,与未行SLN-T淋巴细胞治疗患者进行生存分析,在28.5个月(16~41个月)的随访时间内,两组间中位生存期差异无统计学意义(P>0.05);SLN-T淋巴细胞治疗组生存率为55.6%,大于未行生物治疗组的生存率25.0%,差异有统计学意义(P<0.05);单因素分析显示:患者化疗周期、分化程度、是否进行生物治疗是影响生存率的主要因素。多因素分析显示化疗周期、分化程度是影响生存率的主要因素。结论 SLN-T淋巴细胞免疫疗法治疗伴有远处转移灶不可切除的结直肠癌与未行SLN-T淋巴细胞治疗的患者比较,随访28.5个月(16~41个月)两组中位生存时间无显著差异,但SLN-T淋巴细胞治疗显著提高了患者的生存率,并显示有生存期延长的趋势。
Objective To investigate the clinical efficacy of sentinel lymph node (SLN) -T lymphocyte immunotherapy in the treatment of unresectable stage IV colorectal cancer with distant metastasis. Methods Twenty-five patients with unresectable colorectal cancer with distant metastasis Ⅳ who came to our hospital from November 2011 to June 2016 were divided into treatment group (n = 9) and control group (n = 16) Follow-up observation of their survival. Statistical analysis was performed using SPSS 17.0 software; Kaplan-Meier survival analysis was performed on case data; Log-rank test was used to test survival; and multivariate analysis of COX risk model could influence the prognosis. The patient’s basic clinical features, overall survival (OS) were observed. Results Survival analysis of patients with unresectable colorectal cancer with distant metastases by SLN-T lymphocytes and those without SLN-T lymphocytes was performed at 28.5 months (ranged from 16 to 41 months) There was no significant difference in the median survival time between the two groups (P> 0.05). The survival rate of SLN-T lymphocyte therapy group was 55.6%, which was significantly higher than that of non-biological treatment group (25.0%), the difference was statistically significant (P <0.05). Univariate analysis showed that the patients’ chemotherapy cycle, differentiation degree and biological treatment were the main factors influencing the survival rate. Multivariate analysis showed that the chemotherapy cycle, the degree of differentiation is the main factor affecting the survival rate. CONCLUSIONS: SLN-T lymphocyte immunotherapy for patients with unresectable colorectal cancer with distant metastases is associated with a median survival of 28.5 months (range, 16-41 months) compared with patients not treated with SLN-T lymphocytes There was no significant difference in time, but SLN-T lymphocyte therapy significantly increased patient survival and showed a prolonged survival.