疑难病杂志2025，Vol.24Issue(11)：1323-1328,6.DOI:10.3969/j.issn.1671-6450.2025.11.009
术前短程放疗联合PD-1单抗治疗老年局部晚期直肠癌疗效及对SDC2甲基化的影响
Effects of short-term preoperative radiotherapy combined with PD-1 monoclonal antibody on serum SDC2 levels in locally advanced elderly rectal cancer
摘要
Abstract
Objective To investigate the clinical efficacy of preoperative short-course radiotherapy(SCRT)combined with anti-programmed death receptor-1(PD-1)monoclonal antibody in elderly patients with locally advanced rectal cancer.Methods A retrospective study was conducted on rectal cancer patients admitted to Minda Hospital Affiliated to Hubei Min-zu University from June 2021 to June 2024.After screening,80 patients were enrolled and divided into an observation group(n=40)and a control group(n=40).The observation group received SCRT(25 Gy/5 fractions over 5 days)combined with tirelizumab(200 mg intravenous infusion on day 1,repeated every 3 weeks for 2 cycles)followed by radical surgery.The con-trol group underwent radical surgery 8 to 12 weeks after SCRT alone.Perioperative indicators,disease remission rates,and postoperative complications were compared between the two groups.Results The positive rate of serum SDC2 decreased sig-nificantly after surgery in both groups compared to preoperative levels(P＜0.05).The observation group showed a significantly greater reduction in SDC2 expression than the control group(x2=5.59,P=0.018).Postoperative levels of CD3+,CD4+,and CD4+/CD8+decreased significantly in both groups(all P＜0.05),but these levels were significantly higher in the observation group than in the control group(P＜0.05).No significant differences were observed in operative duration,intraoperative blood loss,time to first flatus,time to first bowel movement,duration of abdominal drainage,or length of hospital stay(all P＞0.05).The objective response rate did not differ significantly between the observation and control groups(75.00％vs.62.50％,x2=1.455,P=0.228),but the disease control rate was significantly higher in the observation group(95.00％vs.77.50％,x2=5.165,P=0.023).Postoperative complication rates were comparable between the two groups(15.00％vs.17.50％,x2=0.092,P=0.762).Conclusion Preoperative SCRT combined with PD-1 monoclonal antibody can effectively improve disease control rates,reduce serum SDC2 positivity,and enhance immune function without compromising surgical safety in elderly patients with locally advanced rectal cancer.关键词
局部晚期直肠癌/术前短程放疗/PD-1单抗/黏结蛋白聚糖2/疗效/老年人Key words
Advanced elderly rectal cancer/Short-course radiotherapy/Anti-programmed death receptor-1/SDC2/Therapeutic effect/Elderly分类
医药卫生引用本文复制引用
文静,杨丽,张微,许琼,吴倩,方呈祥..术前短程放疗联合PD-1单抗治疗老年局部晚期直肠癌疗效及对SDC2甲基化的影响[J].疑难病杂志,2025,24(11):1323-1328,6.基金项目
湖北省自然科学基金计划项目(2022CFB853) （2022CFB853）
恩施州科技计划项目(D20220027) Hubei Provincial Natural Science Foundation Project(2022CFB853) （D20220027）
Enshi Prefecture Science and Technol-ogy Plan Project(D20220027) （D20220027）
