Page 97 - 南京医科大学学报自然科学版

第42卷第6期 南京医科大学学报（自然科学版）
2022年6月 Journal of Nanjing Medical University（Natural Sciences） ·849 ·

·临床研究·

消融联合化疗和单纯化疗在Ⅳ期胰腺癌治疗中的临床和实验

研究

钱祝银 ，余建和 ，程 志 ，陈奕秋 ，朱一超 4
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1 南京医科大学第二附属医院胰腺中心，江苏 南京 210003；兴化市人民医院肿瘤内科，江苏 兴化 225700；南京医科大
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学第二附属医院重症医学科，江苏 南京 210003；南京医科大学生理学系，江苏 南京 211166
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［摘 要］ 目的：比较术中消融联合化疗和单纯化疗在Ⅳ期胰腺癌治疗中的效果，并初步探讨消融联合化疗的潜在细胞学机
制。方法：入选南京医科大学第二附属医院收治的Ⅳ期胰腺癌患者，分为单纯化疗组（化疗组，n=13）与术中消融联合化疗组
（消融组，n=14），分析患者临床资料，对比肿瘤指标、血常规指标及术后生存期等。同时，采用Boyden小室建立人胰腺癌细胞
渗透性实验模型，探究超低温冷冻对人胰腺癌细胞渗透性的影响。结果：消融组治疗后总胆红素（total bilirubin，TB）显著低于
化疗组，而白蛋白（albumin，ALB）显著高于化疗组（P < 0.01）。两组CA19⁃9在治疗前后均没有显著差异。消融组治疗前后的
白细胞数和中性粒细胞百分比均低于化疗组（P < 0.05）。消融组治疗前血小板数高于化疗组（P < 0.05）。化疗组治疗后的红
细胞数显著低于治疗前（P < 0.01）。消融组治疗后的中性粒细胞百分比显著高于治疗前（P < 0.01）。消融组术后的生存期显
著优于化疗组（P=0.019）。经过超低温冷冻的胰腺癌细胞渗透性显著增强（P < 0.01）。结论：术中消融联合化疗较单纯化疗对
Ⅳ期胰腺癌的治疗效果更好，患者生存期延长。
［关键词］ Ⅳ期胰腺癌；术中消融；化疗；生存期；渗透性
［中图分类号］ R735.9 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）06⁃849⁃05
doi：10.7655/NYDXBNS20220613

The clinical and experimental study of ablation therapy combined with chemotherapy or
chemotherapy alone in the treatment of stage Ⅳ pancreatic cancer

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QIAN Zhuyin ，YU Jianhe ，CHENG Zhi ，CHEN Yiqiu ，ZHU Yichao 4
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1 Pancreas Center，the Second Affiliated Hospital of Nanjing Medical University，Nanjing 210003；Department of
Medical Oncology，Xinghua City People’s Hospital，Xinghua 225700；ICU，the Second Affiliated Hospital of Nanjing
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Medical University，Nanjing 210003；Department of Physiology，Nanjing Medical University，Nanjing 211166，China
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［Abstract］ Objective：This study aims to compare the therapeutic effects of ablation therapy combined with chemotherapy and
chemotherapy alone in the treatment of stage Ⅳ pancreatic cancer，and to explore the potential cytological mechanism of ablation
therapy combined with chemotherapy. Methods：Patients with stage Ⅳ pancreatic cancer admitted to the Second Affiliated Hospital of
Nanjing Medical University were divided into two groups：chemotherapy alone group（chemotherapy group，13 cases）and ablation
therapy combined with chemotherapy group（ablation group，14 cases）. The clinical data of patients were analyzed. The tumor indexes，
routine blood indexes，and survival rate were compared between these groups. To study the role of ultralow temperature on the
permeability of pancreatic cancer cells，the permeability assay of pancreatic cancer cells was set up based on Boyden chambers.
Results：The postoperative total bilirubin（TB）in ablation group was lower than that in chemotherapy group，while the postoperative
albumin（ALB）in ablation group was higher than that in chemotherapy group（P < 0.01）. The levels of CA19⁃9 in two groups had no
significant difference. The counts of both pre⁃treatmental and after⁃treatmental white blood cells and the percentages of neutrophils in
ablation group were less than those in chemotherapy group（P < 0.05）. The count of pre⁃treatmental platelet in ablation group was more
than that in chemotherapy group（P < 0.05）. In chemotherapy group，the count of after⁃treatmental red blood cells was less than the

［基金项目］ 江苏省卫生健康委员会医学科研指导性项目（Z2021021）
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通信作者（Corresponding author），E⁃mail：qianzhusilver@163.com