CAJ | 학술논문

目的：评价腹腔内温热灌注化疗对结直肠癌术后外周血中免疫指标的影响。方法将2010-01～2013-12以来手术切除的50例DukesB～C期的结直肠癌患者随机分成温热灌注化疗组及常温灌注化疗组。温热灌注化疗组在手术结束后用含氟尿嘧啶（5-FU）0.5 g／L、丝裂霉素（MMC）8 mg／L、奥沙利铂25 mg／L温热蒸馏水4000 ml，温度控制在43～45℃，在腹腔灌洗1 h。常温灌注化疗组在手术结束后用含5-FU 0.5 g／L、丝裂霉素（MMC）8 mg／L、奥沙利铂25 mg／L常温蒸馏水4000 ml，温度控制在25～30℃，在腹腔灌洗1 h。然后两组分别于术后1月、术后2月再次腹腔灌洗，两组患者均于治疗前、术中、术后1月、术后2月应用ELISA法测定两组患者外周血中IL-2、TNF-α水平。结果与常温灌注化疗组相比，温热灌注化疗组的患者外周血中IL-2、TNF-α水平均明显升高，差异有统计学意义（ P＜0.05）。结论腹腔内温热灌注化疗可促进Thl型免疫漂移，增强机体的抗肿瘤免疫功能，对预防和治疗结直肠癌腹腔内复发与肝转移有一定的作用。
목적：평개복강내온열관주화료대결직장암술후외주혈중면역지표적영향。방법장2010-01～2013-12이래수술절제적50례DukesB～C기적결직장암환자수궤분성온열관주화료조급상온관주화료조。온열관주화료조재수술결속후용함불뇨밀정（5-FU）0.5 g／L、사렬매소（MMC）8 mg／L、오사리박25 mg／L온열증류수4000 ml，온도공제재43～45℃，재복강관세1 h。상온관주화료조재수술결속후용함5-FU 0.5 g／L、사렬매소（MMC）8 mg／L、오사리박25 mg／L상온증류수4000 ml，온도공제재25～30℃，재복강관세1 h。연후량조분별우술후1월、술후2월재차복강관세，량조환자균우치료전、술중、술후1월、술후2월응용ELISA법측정량조환자외주혈중IL-2、TNF-α수평。결과여상온관주화료조상비，온열관주화료조적환자외주혈중IL-2、TNF-α수평균명현승고，차이유통계학의의（ P＜0.05）。결론복강내온열관주화료가촉진Thl형면역표이，증강궤체적항종류면역공능，대예방화치료결직장암복강내복발여간전이유일정적작용。
Objective To evaluate the influence of intraperitoneal hyperthermic perfusion chemotherapy on immune indexes in peripheral blood in postoperative patients with colorectal cancer .Methods From January 2010 to December 2013 ,50 patients with DukesB~C colorectal cancer were randomly divided into two groups:the hyperther-mic perfusion chemotherapy group and the normal temperature perfusion chemotherapy group .After surgery hyperther-mic perfusion chemotherapy group received intraperitoneal hyperthermic distilled water (43~45 ℃) perfusion contai-ning fluorouracil(5-FU)0.5 g/L,mitomycinC(MMC) 8 mg/L oxaliplatin 25 mg/L in 4 000 ml distilled water for 1 hour;the normal temperature perfusion group received intraperitoneal normal temperature distilled water (25~30℃) perfusion containing above drugs in 4 000 ml distilled water for 1 hour.The same perfusions were performed at 1 and 2 months after operation in two groups .Before operation ,during operation and at 1 and 2 months after operation IL-2 and TNF-αin peripheral blood were measured by ELISA in two groups .Results Compared with normal temperature perfusion chemotherapy group ,the levels of IL-2 and TNF-αin hyperthermic perfusion chemotherapy group were sig-nificantly increased ,and the difference was statistically significant ( P<0.05 ) .Conclusion Intraperitoneal hyper-thermic perfusion chemotherapy may promote Thl-type immune drift , enhance the body′s anti-tumor immune function , and have a certain role in prevention and treatment of the peritoneal recurrence and metastases of colorectal cancer .