胸腺肽α1对Ⅱ、Ⅲ期老年食管癌患者新辅助化疗及手术后免疫功能的影响

摘要

Objective:To study the effects of thymosin α1 on cellular immune function in elderly patients with stage of Ⅱ,Ⅲ esophageal cancer after neoadjuvant chemotherapy and surgery. Methods:All 64 elderly patients(aged from 60 to 75)with stage of Ⅱ,Ⅲ esophageal cancer were randomized into two groups:The treatment group consisted of 35 patients receiving chemotherapy with docetaxel and nedaplatin(DP)plus thymosin α1 before surgery,while 29 patients using chemotherapy(DP)alone as control group. Blood samples were drawn on the day of admission,1 day before operation,7 day and 1 month after operation. Flow cytometry was used to detect the levels of CD3 + ,CD4 + , CD8 + ,CD4 + / CD8 + and NK cell. Results:There was no difference in the levels of CD3 + ,CD4 + ,CD8 + ,CD4 + /CD8 + between the treatment group and control group one week later after chemotherapy(P ﹥ 0. 05). The levels of CD3 + ,CD4 + ,CD8 + ,CD4 + / CD8 + ,NK cell activity in the treatment group were higher than those in the control group(P ﹤ 0. 05),and the toxicity of chemotherapy was less in the treatment group(P ﹤ 0. 05)two weeks later after chemotherapy and on the day 7 after operation. Conclusion:Thymosin α1,combined with chemotherapy in elderly pa-tients with stage of Ⅱ,Ⅲ esophageal cancer during neoadjuvant chemotherapy,can reduce the toxicity of chemothera-py,improve the tolerance to chemotherapy and operation,enhance the immune function,and improve the quality of life.%目的：探讨胸腺肽α1对Ⅱ、Ⅲ期老年食管癌患者新辅助化疗及手术后细胞免疫功能的影响。方法：64例60-75岁Ⅱ、Ⅲ期老年食管癌患者随机分为治疗组、对照组两组，治疗组35例，对照组29例，治疗组采用术前 DP（多西他赛＋奈达铂）方案化疗结合胸腺肽α1治疗；对照组只用 DP 方案化疗。分别于化疗前1天、化疗一周期、两周期后、手术后7天抽取患者外周血，采用流式细胞术（flow cyometry，FCM）检测 T 细胞亚群百分率（CD3＋、CD4＋、CD8＋、CD4＋/ CD8＋）及 NK 细胞含量变化。结果：化疗一周期后，两组 CD3＋、CD4＋、CD8＋、CD4＋/ CD8＋水平无差异（P ﹥0.05）；化疗两周期后及术后7天，治疗组 CD3＋、CD4＋、CD8＋、CD4＋/CD8＋及 NK 细胞水平均高于对照组（P ﹤0.05）。化疗毒副反应低于对照组（P ﹤0.05）。结论：胸腺肽α1联合化疗应用于Ⅱ、Ⅲ期老年食管癌新辅助化疗，可减轻毒副反应，提高患者的化疗、手术耐受性及免疫功能，改善生活质量。