摘要目的 观察化疗、热化疗对非小细胞肺癌(NSCLC)患者Th1/Th2平衡及对细胞因子IL-2、干扰素-γ(IFN-γ)、IL-4、IL-10、血管内皮生长因子(VEGF)水平的影响.方法 50例NSCLC患者分为化疗组25例,热化疗组25例,观察其在治疗前后Th1/Th2平衡变化,以及对IL-2、IFN-γ、IL4、IL-10、VEGF的影响,并与健康对照组进行比较.结果 热化疗组较之化疗组Th1细胞比例明显升高(P =0.002),Th2细胞比例降低(P =0.006).治疗前化疗组与热化疗组IL-2、IFN-γ、IL-4、IL-10、VEGF差异均无统计学意义(P＞0.05);而两组与对照组比较差异有统计学意义(P＜0.01).化疗组和热化疗组患者治疗前后血浆IL-2、IFN-γ、IL-4、IL-10水平差异均有统计学意义(P＜0.01),而化疗组治疗前后VEGF变化不明显(P＞0.05).与化疗组治疗后相比,同期热化疗组血浆IL-2、IFN-γ、IL-4、IL-10、VEGF的变化差异有统计学意义(P＜0.05或P＜0.01).结论 热化疗较单纯化疗明显改善Th1/Th2细胞亚群漂移,还可降低VEGF的表达,干预肿瘤新生血管的形成.

abstractsObjective To investigate the effect of hyperthermia combined with chemotherapy on the changes of immunity balance of Th1/Th2 and cytokines such as interleukin-2 (IL-2),interferon-γ (IFN-γ),IL-4,IL-10,and vascular endothelial growth factor (VEGF) in non-small cell lung cancer (NSCLC) patients.Methods Fifty patients with advanced NSCLC were randomly divided into thermochemotherapy group (n =25,received whole body hyperthermia combined TP chemotherapy),and chemotherapy group (n =25,received TP chemotherapy alone).The immunity balance of Th1/Th2,IL-2,IFN-γ,IL-4,IL-10,and VEGF levels before therapy and 1 week after therapy were observed.At the same time,the above observation indices were also detected as normal control in 20 healthy volunteers.Results Compared to the chemotherapy group,the proportion of Th1 cells from thermochemotherapy group was significantly increased after therapy (P =0.002) and that of Th2 cells was dropped markedly (P =0.006).There was no difference in the levels of IL-2,IFN~,IL4,IL-10,and VEGF between thermochemotherapy and chemotherapy groups before therapy (P ＞ 0.05).However,the expressions of ILA,IL-10,and VEGF in the NSCLC group were significantly higher than normal group (P ＜ 0.01).The IL-2 and IFN-γ levels were significantly decreased in NSCLC group (P ＜0.01).After therapy 1 week,the concentration of IL-2 and IFN-γfrom thermochemotherapy and chemotherapy groups were higher than before,with statistical significance (P ＜0.01).In addition,IL-4 and IL-10 levels of two groups were significantly decreased in comparison with before therapy (P ＜ 0.01),and it showed a striking difference in cytokines (IL-2,IFN-γ,IL-4,and IL-10) between two groups (P ＜ 0.05).However,the concentration of VEGF in chemotherapy group patients before and after chemotherapy had no significant difference (P ＞ 0.05).The concentration of VEGF from thermochemotherapy group patients after therapy were lower than chemotherapy group patients,the difference had statistical significance (P ＜ 0.01).Conclusions Thermochemotherapy can significantly prompt the Th2 to Th1 shift in both cells and cytokines of advanced NSCLC compared to chemotherapy alone.Moreover,thermochemotherapy also reduces the expression of VEGF,which may prevent the formation of new blood vessels in tumor tissue.