高强度聚焦超声与新辅助化疗对乳腺癌患者免疫功能的影响

目的通过研究乳腺癌患者细胞免疫功能的变化比较高强度聚焦超声(HIFU)消融术与新辅助化疗术前辅助治疗乳腺癌的疗效。方法本研究为开放、随机、对照试验。60例经穿刺病理确诊的乳腺癌患者随机分为HIFU消融组(I组30例)和新辅助化疗组(II组30例),另设对照组30例,均为乳腺良性疾病患者,分别于试验组治疗开始前、术前及对照组术前抽取患者静脉血,采用流式细胞术检测外周血中CD3+、CD4+、CD8+T细胞百分比及CD4+/CD8+的变化情况。结果试验组治疗前CD3+、CD4+、CD4+/CD8+均明显低于对照组(P<0.05),CD8+T细胞百分比明显高于对照组(P<0.05);I组消融后CD3+、CD4+、CD4+/CD8+明显高于消融前(P<0.05),CD8+T细胞百分比明显低于消融前(P<0.05);II组化疗前后各免疫指标差异无统计学意义(P>0.05);I组消融后CD3+、CD4+、CD4+/CD8+水平明显高于II组化疗后(P<0.05)。结论乳腺癌患者细胞免疫功能受抑制,术前行HIFU治疗可明显改善机体免疫功能,HIFU有望成为一种新的术前辅助治疗手段。

Effect of high intensity focused ultrasound and neoadjuvant chemotherapy on cellular immune function in patients of breast cancer

【Objective】 To investigate the therapeutic efficacy of breast cancer treated with high intensity focused ultrasound(HIFU) ablation ang neoadjuvant chemotherapy on the changes of cellular immune function.【Methods】 This study is an open,randomized,controlled trial.60cases confirmed by biopsy in breast cancer patients randomly assigned to HIFU group(I group,30cases) and neoadjuvant chemotherapy group(II group,30cases),a separate control group,30 cases were patients with benign breast disease.Respectively in the experimental group before the start of treatment,preoperative and control group patients with venous blood collected before surgery,use the flow cytometry to Detect the changes of peripheral blood CD3+,CD4+,CD8+T cell percentage.【Results】 Breast cancer group CD3+,CD4+,CD4/CD8+ were significantly lower than the control group(P<0.05),CD8+T cell percentage was significantly higher(P <0.05);I group after ablation CD3+,CD4+,CD4/CD8+ was higher than the ablation front(P<0.05),CD8+cells was significantly lower than before ablation(P<0.05);II immune parameters before and after chemotherapy was no significant difference(P>0.05);I group after ablation CD3+,CD4+,CD4/CD8+levels were significantly higher than group II after chemotherapy(P<0.05).【Conclusion】 Breast cancer patients with suppressed immune function,preoperative HIFU ablation can significantly improve immune function,HIFU is expected to become a new means of preoperative adjuvant therapy.