卡培他滨同步放化疗对局部晚期直肠癌患者血清T细胞、VEGF、CEA、COL IV的影响

目的:研究卡培他滨同步放化疗对局部晚期直肠癌（locally advanced rectal cancer，LARC）患者血清T细胞、血管内皮生长因子（VEGF）、癌胚抗原（carcinoembryonic antigen,CEA）、IV型胶原（collegen type IV，COL IV）的影响。方法:将2014年1月-2018年6月于我院治疗的晚期LARC患者164例纳入本研究，依照随机数字表法分为实验组（n=82）与对照组（n=82）。对照组术后行放射治疗，实验组术后行卡培他滨同步放化疗。治疗前后，观察两组患者血清CD3+CD4+、CD3+CD56+、CD3+CD4+/CD3+CD8+等T细胞水平，血管内皮生长因子（VEGF）水平，血清CEA、COL IV、CA199水平，毒副反应。结果:治疗后，实验组CD3+CD4+、CD3+CD56+、CD3+CD4+/CD3+CD8+均高于对照组（P<0.05）。实验组VEGFA、VEGFB、VEGFC、CEA、COL IV、CA199水平均低于对照组（P<0.05）。实验组ORR率（58.54%）、DCR率（90.24%）均高于对照组（37.80%、74.39%）（P<0.05）。两组各毒副反应发生率无差异（P>0.05）。结论:卡培他滨同步放化疗可有效杀灭LARC患者肿瘤细胞，解除机体免疫抑制，抑制分泌VEGF、CEA、COL IV，疗效显著，较为安全，可应用于临床。

Effect of concurrent radiotherapy and chemotherapy with capecitabine on serum T cells，VEGF，CEA，COL IV in patients with locally advanced rectal cancer

Objective:To study the effect of capecitabine combined with simultaneously radiotherapy and chemotherapy on serum T cells，VEGF，CEA，COL IV in patients with locally advanced rectal cance(LARC).Methods:164 patients with advanced LARC who were treated in our hospital from January 2014 to June 2018 were included in this study.The control group received radiotherapy after operation，and the experimental group received concurrent radiotherapy and chemotherapy with carbetabine.Before and after treatment，the serum levels of CD3+CD4+，CD3+CD56+，CD3+CD4+/CD3+CD8+ and T cells in the two groups were observed.Vascular endothelial growth factor(VEGF）level，serum CEA，COL IV，CA199 level，toxicity were also observed.Results:After treatment，the levels of CD3+CD4+，CD3+CD56+，CD3+CD4+/CD3+CD8+ in the experimental group were higher than those in the control group(P<0.05).The level of VEGFA，VEGFB，VEGFC，CEA，COL IV，CA199 in the experimental group was lower than that in the control group(P<0.05).The ORR rate，DCR rate in the experimental group(58.54%，90.24%）was higher than that in the control group(37.80%，74.39%)(P<0.05).There was no difference in the incidence of side effects between the two groups(P>0.05).Conclusion:Concurrent radiotherapy and chemotherapy with capecitabine can effectively kill tumor cells in patients with advanced rectal cancer，improve body immunity and inhibit secretion of VEGF，CEA，COL IV.It is safe and effective and can be used in clinical practice.