胆囊癌患者术后放疗对免疫及炎性状态的综合影响观察

[摘要] 目的 探讨术后放疗对胆囊癌患者免疫及炎性状态的综合影响。 方法 选取2007年8月～2011年6月于本院采用适形调强放疗（IMRT）的40例胆囊癌患者为观察组，同期采用三维适形放疗（3DCRT）的40例患者为对照组，将两组患者放疗前及放疗结束后1、4周的外周血T淋巴细胞亚群、红细胞免疫功能、免疫球蛋白及其补体、血清超敏C反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）、白介素6（IL-6）、γ干扰素（IFN -γ）、白介素4（IL-4）水平进行检测及比较。 结果 观察组放疗前至放疗结束后1、4周外周血T淋巴细胞亚群、红细胞免疫功能、免疫球蛋白及其补体、血清hs-CRP、TNF-α、IL-6、IFN-γ、IL-4水平波动幅度小于对照组，且放疗后4周优于放疗前（均P ＜ 0.05）。 结论 适形调强放疗较三维适形放疗对胆囊癌患者免疫抑制及炎症反应更为轻微，说明其对患者的不良影响更小。

[关键词] 术后放疗；三维适形放疗；适形调强放疗；胆囊癌；免疫；炎症状态；综合影响

[中图分类号] R735.8 [文献标识码] A [文章编号] 1673-7210（2012）08（b）-0052-03

Observation on the comprehensive influence of three-dimensional conformal radiotherapy for the immune and inflammatory state of patients with gallbladder carcinoma

YANG Jing YE Yunfei ZHOU Haihua SUN Yongjian MENG Yan

Center of Radiotherapy, the Eastern Hepatobiliary Surgery Hospital Affiliated to the Second Military Medical University, Shanghai 200438, China

[Abstract] Objective To study the comprehensive influence of postoperative radiotherapy for the immune and inflammatory state of patients with gallbladder carcinoma. Methods 40 patients with gallbladder carcinoma who were treated with IMRT in our hospital from August 2007 to June 2011 were selected as observation group, and 40 patients treated with 3DCRT at the same time were selected as control group, then the peripheral blood T lymphocyte subsets, erythrocyte immune function, immunoglobulin and its complements, serum serum high-sensitivity c-reactive protein (hs-CRP), tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), Interferon γ (IFN-γ), interleukin 4 (IL-4) of two groups before and after the radiotherapy at first and forth week were detected and compared. Results The fluctuation range of peripheral blood T lymphocyte subsets, erythrocyte immune function, immunoglobulin and its complements, hs-CRP, TNF-α, IL-6, IFN-γ, IL-4 of observation group before the radiotherapy to after the radiotherapy at first and forth week were smaller than those of control group, and the levels after the radiotherapy at the forth week were better than those before the radiotherapy, there were all significant differences (all P ＜ 0.05). Conclusion The immunosuppression and inflammatory response of IMRT for the patients with gallbladder carcinoma is smaller than that of 3DCRT, and it shows that the harmful effects for the patients is smaller.

[Key words] Postoperative radiotherapy; 3DCRT; IMRT; Gallbladder carcinoma; Immune; Inflammatory state; Comprehensive influence