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【目的】研究CT引导下射频消融联合靶向治疗对中晚期非小细胞肺癌患者免疫功能的影响。【方法】将80例诊断为中晚期非小细胞肺癌的患者随机分为对照组与观察组,每组40例。两组患者均给予吉非替尼联合顺铂与紫杉醇靶向治疗,观察组在靶向治疗的基础上行在CT与超声引导下经皮射频消融术,治疗前及治疗后4周测定细胞免疫及体液免疫功能并进行比较。【结果】治疗后观察组患者血清CD3[(64.53%±6.53%)vs(58.67%±4.54%)]、CD4[(39.48%±4.13%)vs(35.32%±3.43%)]、自然杀伤细胞[(23.65%±2.87%)vs(21.74±1.84%)]、Ig G[(16.32±1.21)g/L vs(14.64±1.32)g/L]、Ig M[(2.12±0.19)g/L vs(1.81±0.16)g/L]、Ig A[(2.78±0.33)g/L vs(2.59±0.16)g/L]浓度与CD4/CD8(1.47±0.18 vs 1.22±0.15)较治疗前有所升高(P<0.05),CD8[(23.43%±2.78%)vs(27.54%±2.21%)]较治疗前有所降低(P<0.05)、而对照组上述指标与观察组相反;治疗后观察组患者血清CD3[(64.53%±6.53%)vs(55.32%±5.43%)]、CD4[(39.48%±4.13%)vs(30.43%±3.09%)]、CD4/CD8(1.47±0.18 vs 1.14±0.14)、NK[(23.65%±2.87%)vs(17.54%±1.67%)]、Ig G[(16.32±1.21)g/L vs(11.22±0.65)g/L]、Ig M[(2.12±0.19)g/L vs(1.56±0.21)g/L)、Ig A[(2.78±0.33)g/L vs(2.34±0.31)g/L]高于对照组(P<0.05),观察组CD8[(23.43%±2.78%)vs(29.32%±2.78%)]较对照组低(P<0.05)。【结论】中晚期肺癌患者接受射频消融术联合靶向治能很好的改善免疫功能,是一种安全可靠且创伤较小的治疗方法,有很好的临床应用前景。
【Objective】 To investigate the effect of CT-guided radiofrequency ablation combined with targeted therapy on immune function in patients with advanced non-small cell lung cancer. 【Methods】 Eighty patients diagnosed as advanced non-small cell lung cancer were randomly divided into control group and observation group, 40 cases in each group. Both groups were given gefitinib combined with cisplatin and paclitaxel targeted therapy, the observation group on the basis of targeted therapy under CT and ultrasound guided percutaneous radiofrequency ablation, before and after treatment for 4 weeks to determine the cellular immunity and Humoral immune function and comparison. 【Results】 The levels of CD3 (64.53% ± 6.53% vs 58.67% ± 4.54%), CD4 (39.48% ± 4.13%) vs 35.32% ± 3.43% (23.65% ± 2.87% vs 21.74 ± 1.84%, Ig G [(16.32 ± 1.21) g / L vs (14.64 ± 1.32) g / L] (1.81 ± 0.16) g / L and Ig A [(2.78 ± 0.33) g / L vs (2.59 ± 0.16) g / L] and CD4 / CD8 (1.47 ± 0.18 vs 1.22 ± 0.15) (23.43% ± 2.78% vs 27.54% ± 2.21%) than those before treatment (P <0.05), while those in the control group were opposite to those in the observation group After treatment, the levels of CD3 (64.53% ± 6.53% vs 55.32% ± 5.43%), CD4 (39.48% ± 4.13%) vs (30.43% ± 3.09%) and CD4 / CD8 (1.47 ± 0.18% vs 1.14 ± 0.14), NK (23.65% ± 2.87%) vs (17.54% ± 1.67%), Ig G (16.32 ± 1.21) g / L vs 11.22 ± 0.65 g / (2.12 ± 0.19) g / L vs (1.56 ± 0.21) g / L and Ig A [(2.78 ± 0.33) g / L vs (2.34 ± 0.31) g / L] The observation group CD8 [(23.43% ± 2.78%) vs (29.32% ± 2.78%)] lower than the control group (P <0.05). 【Conclusion】 Radiofrequency catheter ablation combined with targeted therapy can improve immune function in patients with advanced lung cancer. It is a safe, reliable and less invasive treatment and has good clinical application prospects.