Therapeutic effects of neoadjuvant chemotherapy combined with laparoscopic surgery on advanced gastric carc inoma ;and its effects on patient ’ s immune function at peroperative period

ZHANG Jianbin

doi:10.3969/j.issn.1002-7386.2015.19.006

Abstract：Objective To observe the clinical efficiency of neoadjuvant chemotherapy combined with laparoscopic surgery on advanced gastric carcinoma and its effects on patient’ s immune function at peroperative period.Methods A total of 110 patients with advanced gastric carcinoma who were admitted into our hospital from January 2013 to January 2015 were randomly divided into observation group ( n =55) and control group ( n =55) .The patients in control group were treated by laparoscopic surgery,however,the patients in observation group,on the basis of control group, were treated by preoperative neoadjuvant chemotherapy.After treatment, the clinical curative effects, the changes of CD3+, CD4+,CD8+,CD4+/CD8+,NK cells activity, IgA, IgG, IgM were observed and detected in both groups.The patients were followed up for 3 years.The relapse rate, metastasis rate, fatality rate, tumor-free survival time and overall survival time were observed and detected. Results The total effective rates and resective rates in observation group were 76.36% (42/55)and 83.64% (46/55), respectively,which in control group were 56.36%(31/55), 69.09% (38/55), respectively, there were significant differences between two groups ( P <0.05 ) .However there were no significant differences in toxic reactions and incidences of postoperative complications between two groups ( P >0.05).After treatment,the CD3+,CD4+,CD8+,CD4+/CD8+,NK cells activity, IgA, IgG, IgM were obviously improved,as compared with those before treatment in both groups ( P <0.05), moreover, the improvement degree in observation group was more obvious than that in control group ( P <0.05).The relapse rate,metastasis rate and mortality rate in observation group were significantly lower than those of control group,furthermore, the tumor-free survival time and overall survival time in observation group were obviously longer than those of control group (P<0.05).Conclusion The preoperative neoadjuvant chemotherapy combined with laparoscopic surgery can obviously improve cellular and humoral immune function of patients with advanced gastric cancer at perioperative period, which can reducepostoperative relapse rate and can prolong patient ’ s survival time,with less toxic and adverse reactions,thus it is worthy to be widely applied in clinic.