Dynamic study of immunoregulatory factors and tumor markers in patients with advanced gastric cancer before and after chemotherapy / 中国综合临床

ABSTRACT

Objective To analyze the dynamic changes of immunoregulatory factors and tumor markers before and after chemotherapy in patients with advanced gastric cancer.Methods From October 2015 to February 2018,58 patients with chemotherapy AGC in our hospital were selected as gastric cancer group.According to the efficacy of chemotherapy they were divided into effective group, stable group and ineffective group.Meanwhile,30 healthy persons were selected as normal group.The immunoglobulins (IgA, IgG,IgM), T lymphocyte subsets ( CD3+, CD4+, CD8+, CD4+／CD8+) and related tumor markers ( CEA, CA199,CA242) were compared before and after chemotherapy.Results The levels of IgA((2.11±0.89) g／L),IgM((10.65±4.61) g／L),IgG((1.25±0.45) g／L),CD8+((28.12±3.56)%),CEA((40.33 ±16.24) μg／L),CA199((76.34±21.56) kU／L) and CA242((29.34±9.57)k U／L) in the gastric cancer group were significantly higher than those in the normal group IgA((0.93±0.36) g／L),IgM((6.46±3.59) g／L),IgG((0.65±0.32) g／L),CD8+(( 25.02± 4.78)%),CEA((1.81± 0.55) μg／L),CA199((7.51 ±2.67) kU／L),CA242((3.35±1.21) kU／L) (t＝6.958,3.600,6.495,3.435,12.952,17.370,14.773, P＜0.05),while CD3+(( 64.12± 5.12)%),CD4+(( 34.12 ± 4.10)%),CD4+／CD8+( 1.09 ± 0.28) were lower than the normal group (CD3+(71.23±7.14)%,CD4+( 39.78±5.20)%,CD4+／CD8+( 1.47±0.40)) (t＝5.376,5.592,5.192,P＜0.05).The total effective rate of AGC patients in gastric cancer group was 79.31 %(46／58),and the ineffective rate was 20.69%(12／58).IgA,IgG,IgM,and CD8+in the effective group were significantly lower than those before chemotherapy (t＝3.925,3.745,4.036,2.661,P＜0.05), while CD3+,CD4+, CD4+／CD8+ were significantly higher than before chemotherapy ( t＝3.520, 3.077, 3.218,P＜0.05).The subcellular level of protein and T lymphocytes was significantly better than that of stable group and ineffective group (P＜0.05).The levels of tumor markers CEA,CA199 and CA242 in the effective group and stable group were significantly lower than those before chemotherapy ( P＜0.05), and significantly lower than the ineffective group ( P＜0.05).Conclusion The levels of immunoglobulins, T lymphocyte subsets and tumor markers in patients with AGC have significant changes after chemotherapy,and their levels can guide the efficacy of chemotherapy.