【摘要】 目的探讨腹腔温热化疗(IHCP)对进展期胃癌术后生存率影响的机制。方法将进展期胃癌术后患者79例随机分为腹腔温热化疗组37例、全身化疗组42例,按氟尿嘧啶(5-FU)+顺铂(DDP)+羟喜树碱(HCPT)方案分别进行化疗,化疗期间监测T细胞亚群、自然杀伤(NK)细胞变化及不良反应,并对两组进行5年期随访。结果两组切口并发症、感染、肠梗阻、肝功能受损、脱发以及血小板降低发生率差异均无统计学意义(P>0.05);腹腔温热化疗组胃肠道反应和白细胞降低发生率与全身化疗组比较,差异有统计学意义(P<0.05)。两组前3个疗程T细胞亚群和NK细胞比较差异无统计学意义(P>0.05);3个疗程后,腹腔温热化疗组CD4+、CD4+/CD8+和NK细胞显著上升(P<0.05)。术后5年期随访结果显示,腹腔温热化疗组生存率明显高于全身化疗组(P<0.01)。结论术后腹腔温热化疗对患者细胞免疫功能影响较小,可提高进展期胃癌患者的术后生存率。更多还原

【Abstract】 Objective To understand the possible mechanisms of intraperitoneal hyperthermia chemotherapy (IHCP) in benefiting survival of postoperative patients with advanced gastric cancer.Methods 79 postoperative patients with advanced gastric cancer were allocated into group A (n=37) and group B (n=42) randomly.Both groups were treated with a schedule of 5-FU + DDP + HCPT.37 cases in group A were given IHCP,while 42 cases in group B were treated with systemic chemotherapy.The values of subset of T lymphocytes and NK cells in the two groups were monitored during the chemotherapy.All patients in both the groups were followed up for a 5-year schedule.Results Both group A and group B had similar ratio of complication of cut,infection,intestinal obstruction,damage of hepatic function,trichomadesis and platelet drawdown (P>0.05).The difference of the ratio of adverse reaction in gastrointestinal tract and leucocyte drawdown between group A and group B was significant (P<0.05).Before chemotherapy,the values of subset of T lymphocytes and NK cells in the two groups were similar (P>0.05),but after three rounds of therapy,cell levels of CD4+,CD4+/CD8+ and NK of group A increased significantly (P<0.05).The results of the 5-year-follow-up schedule showed that the survival rate of group A was higher than that of group B (P<0.01).Conclusion IHCP may have slighter adverse effect on cellular immune function,and IHCP can improve the survival rate of postoperative patients with advanced gastric cancer.更多还原