术前放化疗对中晚期食管癌免疫功能的影响

摘要

Objective:To explore the changes of immunity function before and after neoadjuvant therapy in the treatment of resectable Advanced Esophageal Cancer( AEC ). Methods: A total of 138 patients with locally advanced ( T3 -4NXM0 ) AEC were studied. They were allocated to two groups: surgery alone ( S - group ) or Neoadjuvant chemoradiotherapy followed by surgery ( NCRT - group ). Results: The function of immunity were significantly lower in AEC patients after NCRT( P ＜ 0.05 ),whereas ,T -lynphocyte subgroup immunity were significantly higher after surgery P ＜ 0.05 ) and there were no significant different between two groups( P ＞ 0.05 ). NK cells were higher in efective group than those in pre -treatment samples( P ＜ 0.05 ), CD4 +/CD8 + didnt change( P ＞ 0.05 ). However,in invalid group NK cell and CD4 +/CD8 + were lower than those in pre - treatment patients ( P ＜ 0.05 ). Conclusion: The immunity was suppressed in patients with AEC. CD4 +/CD8 + have no change significantly in efective group, but it changes markedly in invalid group.%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.