本文選題：免疫抑制 + T淋巴細胞�。� 參考：《南京大學》2016年碩士論文

【摘要】：背景：胃癌一直是危害人類健康的重大疾病,我國的發(fā)病率一直居高不下,全球每年大約新發(fā)病例的50%出現(xiàn)在我國,而且我國胃癌患者絕大部分是進展期胃癌,治療效果不甚理想。胃癌的治療是以手術(shù)為主的綜合治療,但多年的臨床實踐證明,對進展期胃癌的療效并非與手術(shù)范圍的無限擴大成正比,因此術(shù)前化療也就成為臨床上治療進展期胃癌的主要手段。我們采用動靜脈結(jié)合的術(shù)前化療治療因局部進展嚴重而無法切除的胃癌患者。本研究目的是探究胃癌動靜脈結(jié)合的術(shù)前化療對病人T淋巴細胞亞群的影響。方法：選取局部進展嚴重且無法切除(ⅢB與ⅢC的105例胃癌患者,采用動靜脈結(jié)的術(shù)前化療共2周期,方案為FLEEOX。方法為：在第1～5天緩慢靜脈滴注氟尿嘧啶370mmg/m2；第1-5天靜滴亞葉酸鈣200mg/m2；奧沙利120mg/lIl2、多柔比量30mg/In2以及足葉乙甙70mg/m2,分別在第6、 20天用動脈介入將導(dǎo)管插至腹腔干,而后將化療藥物注射到供給癌腫所在的血管內(nèi)�；熃Y(jié)束后復(fù)查全腹增強CT及外周血中T淋巴細胞抗原(CD3+ 、CD4+CD3+、CD8+CD3+、 CD4+/CD8+)及部分抗原比值。以腫瘤體積變化大小分成有效組和無效組。觀察化療前不同分期胃癌病人的T淋巴細胞抗原及部分抗原比值及化療前后兩組患者T淋巴細胞抗原及部分抗原比值的變化。結(jié)果：所有105例病人中,術(shù)前化療有效率為78.1%(82/105)；化療前ⅢC期患者與ⅢB期患者的外周靜脈血中CD3+T淋巴細、CD4+CD3+ T淋巴細胞、CD8+CD3+ T淋巴細胞的百分比均值及CD4+/CD8+比值未見明顯變化(P0.05)；有效組：化療前與化療后CD3+T淋巴細胞、CD4+CD3+T淋巴細胞、CD8+CD3+ T淋巴細胞的百分比均值均升高,差值具有統(tǒng)計學意義(P0.05)；無效組：化療前與化療后CD3+T淋巴細胞、CD4+CD3+ T淋巴細胞的百分比均值及CD4+/CD8+比值均升高,差值具有統(tǒng)計學意義(P0.05)。結(jié)論：局部進展嚴重的ⅢB與ⅢC期胃癌患者的細胞免疫功能無明顯差異；術(shù)前動靜脈結(jié)合化療能夠緩解腫瘤對宿主的免疫抑制。
[Abstract]:Background: gastric cancer has been a major disease endangering human health. The incidence of gastric cancer in China has been high. About 50% of the new cases in the world occur in China every year, and the majority of gastric cancer patients in China are advanced gastric cancer. The therapeutic effect is not satisfactory. The treatment of gastric cancer is based on surgical treatment, but clinical practice for many years has proved that the curative effect of advanced gastric cancer is not proportional to the unlimited expansion of the scope of surgery. Therefore, preoperative chemotherapy has become the main clinical treatment of advanced gastric cancer. We used preoperative chemotherapy combined with arteriovenous therapy for patients with unresectable gastric cancer due to severe local progression. The aim of this study was to investigate the effect of preoperative chemotherapy combined with arteriovenous therapy on T lymphocyte subsets in patients with gastric cancer. Methods: 105 patients with advanced and unresectable gastric cancer (鈪，

本文編號：2005219