目的 探索免疫营养对接受新辅助放化疗的直肠肿瘤患者肿瘤浸润性 T 淋巴细胞和调节性 T 细胞的影响。 方法 前 瞻性选取 2020 年 9 月至 2023 年 6 月期间华中科技大学同济医学院附属梨园医院肿瘤科收治的 120 例直肠肿瘤患者为研究 对象,根据随机数字表法分为两组,对照组 60 例采用常规营养治疗,试验组 60 例采用免疫营养支持,均在治疗 14 d 后比较肿 瘤细胞增殖和凋亡情况[细胞增殖指数( PI)、细胞凋亡指数(AI)、AI/ PI]、胃肠激素水平[血管活性肠肽(VIP)、胃动素 (MTL)、胃泌素(GAS)]、肿瘤浸润和调节 T 淋巴细胞数量(Th3、TGF-β、CD3 + T 细胞、CD8 + T 细胞)以及治疗后 30 d 的营养状 态[前白蛋白(PA)、血红蛋白(Hb)、白蛋白(ALB)]。 结果 两组患者接受治疗后,肿瘤细胞增殖和凋亡情况、胃肠激素水平、 营养状态、肿瘤浸润和调节 T 淋巴细胞数量改善情况均较同组治疗前更优,差异有统计学意义(P<0. 05)。 两组治疗后效果比 较,试验组 PI、AI、AI/ PI、VIP、MTL、GAS、Th3、TGF-β、CD3 + T 细胞、CD8 + T 细胞改善情况优于对照组,差异有统计学意义(P< 0.05)。 同时,试验组治疗后的 PA、Hb、ALB 水平高于对照组,差异有统计学意义(P<0.05)。 结论 对接受新辅助放化疗的直肠肿瘤患者进行免疫营养治疗,能够促进肿瘤细胞凋亡,抑制肿瘤细胞分化和增殖,改善营养状态和胃肠功能,提高机体免疫 力,是直肠肿瘤优选治疗模式。

Objective To explore the effects of immunonutrition on tumor-infiltrating T-lymphocytes and regulatory T-cells in rectal tumor patients receiving neoadjuvant chemoradiotherapy. Method Prospective selected 120 rectal tumor patients admitted to the Oncology Department of Liyuan Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from September 2020 to June 2023 divided into 2 groups according to the random number table method. The control group of 60 patients were treated with routine nutritional support in the observation group 60 patients received immunonutritional support cancer cell proliferation and apoptosis PI AI AI / PI gastrointestinal hormone levels VIP MTL GAS tumor infiltration and regulatory T lymphocyte numbers Th3 TGF-β CD3 + CD8 + and nutritional status PA Hb ALB at 30d after treatment. Result Cancer cell proliferation and apoptosis gastrointestinal hormone levels nutritional status tumor infiltration and regulated T lymphocytes were better than before treatment P <0. 05 . Comparison of the post-treatment effects between the two groups observation group PI AI AI / PI VIP MTL GAS Th3 TGF-β CD3 + CD8 + . the improvement was better than that in the control group The difference was statistically significant P<0. 05 . Meanwhile the treated PA Hb ALB were higher than the control group with statistically significant differences P<0. 05 . Conclusion Immunonutritional support for rectal tumor patients receiving neoadjuvant radiotherapy and chemotherapy can promote cancer cell apoptosis inhibit cancer cell differentiation and proliferation improve nutritional status and gastrointestinal function and improve body immunity which is the preferred treatment mode for rectal tumor.