5-氟尿嘧啶缓释剂瘤内植入对胰腺癌患者肿瘤标记物和细胞免疫的影响

目的　观察 5 氟尿嘧啶 (5 FU)缓释剂瘤内植入对胰腺癌患者血清肿瘤标记物和细胞免疫的影响 ,评估其临床疗效。方法　 2 0 0 0年 1月至 2 0 0 3年 2月经手术探查不能切除之胰腺癌 6 9例随机分成 3组。 5 FU缓释剂瘤内植入治疗组 :手术中在胰腺肿瘤实体内注入 5 FU缓释剂 2 0 0mg ;术后行 5 FU静脉化疗组 :5 FU静脉滴注 5 0 0mg/d ,共 5d ;对照组 :术后 2周内未予化疗。所有病人分别于术前 1天和术后第 14天采血 ,测定血清中NK细胞、T细胞亚群和CEA、CA5 0、CA19- 9、CA12 5、CA2 4 2等 5种血清肿瘤标记物水平。结果　 (1)治疗前各组在CD3+ 、CD4 + 、CD8+ 、CD4 + /CD8+ 和NK细胞等各项细胞免疫指标水平和血清肿瘤标记物CEA、CA5 0、CA19- 9、CA12 5和CA2 4 2水平无显著差异 (P >0 .0 5 ) ;(2 )术后 5 FU缓释剂瘤内植入治疗组和对照组的上述各项细胞免疫指标无显著差异 (P >0 .0 5 ) ,而CD4 + /CD8+ 和NK细胞水平两组均高于静脉 5 FU化疗组(P <0 .0 5 ) ;(3)术后 5 FU缓释剂瘤内植入治疗组上述血清肿瘤标记物水平明显低于对照组和静脉 5 FU化疗组 (P <0 .0 5 )。结论　 5 FU缓释剂植入胰腺癌实体内 ,能明显降低CEA、CA5 0、CA19- 9、CA12 5、CA2 4 2等血清肿瘤标记物水平 ,同时对患者的细胞

Effect of Intra-tumor Embedding of Slow-release 5-Fluorouracil on Serum Tumor Biomarkers and Cellular Immunity of Patients with Pancreatic Carcinoma

Purpose To investigate the therapeutic effectiveness of intra-tumor embedding of slow-release 5-fluorouracil (5-FU) on unresectable pancreatic carcinoma in human. Methods 69 cases with unresectable pancreatic carcinoma were divided into 3 groups randomly:intra-tumor embedding of slow-release 5-FU treated group,intra-vein injection of 5-FU treated group and controlled group.The serous values of CD3 +,CD4 +,CD8 +,CD4 +/CD8 +,NK cells,CEA,CA50,CA19-9,CA125 and CA242 were measured in all patients 1 day before and 14 days after operation. Results Before treatment,there were no difference of the serous values of NK cells,T lymphocyte phenotypes and above tumor biomarkers among the three groups (P>0.05).After treatment,the serous levels of CD4 +/CD8 + and NK cells were much lower in the intra-vein injection 5-FU treated group than these in the intra-tumor embedding of slow-release 5-FU treated group and the controlled group (P<0.05),and the serous values of CEA,CA50,CA19-9,CA125, and CA242 of the patients were much lower in the intra-tumor embedding of slow-release 5-FU treated group than in the intra-vein injection of 5-FU treated group and the controlled group (P<0.05). Conclusions Intra-tumor embedding of slow-release 5-FU has less damage of cellular immunity and is helpful to decrease the serous values of CEA,CA50,CA19-9,CA125 and CA242,so it is an useful method for treating patients with unresectable pancreatic cancinoma.