Saraswati Wita, Dahlan Erry Gumilar, Saputra Koosnadi, Sutrisno Thomas Cahyono
Obstetrics and Gynecologic Department, Rumah Sakit Dokter Soetomo General Hospital, Surabaya, Jawa Timur, Indonesia.
Faculty of Medicine, Universitas Airlangga, Surabaya, Jawa Timur, Indonesia.
Med Acupunct. 2019 Feb 1;31(1):29-36. doi: 10.1089/acu.2018.1316. Epub 2019 Feb 7.
A natural-killer (NK) cell is a cytotoxic lymphocyte that responds to tumor formation. Electroacupuncture (EA) in patients with cancer, who had chemotherapy, enabled them to maintain their T-cell counts (CD3+, CD4+, and CD8+) and NK-cell activity. To evaluate NK-cell levels and tumor sizes in patients with cervical squamous-cell carcinoma (SCC) after EA on ST 36 (). This study was a randomized, experimental clinical study with a pre-post-test, control group design. Setting The study was performed in the obstetrics and gynecology department, Gynecology Oncology Division of the Rumah Sakit Dokter Soetomo General Hospital, in Surabaya, Jawa Timur, Indonesia, conducted from February 2016 until May 2016. Patients with cervical SCC, stages IIb-IIIb (locally advanced)-determined clinically and histopathologically-all of whom had 50 mg/m/week of cisplatin chemotherapy. The patients were divided, consecutively, into 2 groups by simple random sampling. The controls received only received the chemotherapy, while treatment-group patients also had EA 1 day on bilateral ST 36 after each chemotherapy cycle. Primary outcomes were percent of NK cells and tumor size. Before the first treatment and after the fourth one, all patients underwent peripheral blood examinations (complete blood counts, serum creatinine and blood-urea-nitrogen levels, and flow-cytometry) to determine percentages of NK cells, and pelvic magnetic resonance imaging to measure cervical tumor sizes. Secondary outcomes were pain, nausea, vomiting, and appetite. There was a significant increase in number of NK cells ( = 0.00) and a significant decrease in tumor sizes ( = 0.03) in the treatment group, compared to the control group. There was a significant increase in appetite ( = 0.00) in the treatment group, compared to baseline, but there were no significant differences in pain ( = 0.061), nausea ( = 0.399), and vomiting ( = 0.854). Patients with cervical SCC at stages IIb-IIIb, who received 4 cycles of chemotherapy using 50 mg/m/week of cisplatin and EA at ST 36, had increased NK-cell percentages in their peripheral blood and had reductions in their cervical tumors.
自然杀伤（NK）细胞是一种对肿瘤形成有反应的细胞毒性淋巴细胞。对接受化疗的癌症患者进行电针治疗，可使他们维持T细胞计数（CD3 +、CD4 +和CD8 +）以及NK细胞活性。为了评估电针刺激足三里穴（ST 36）后宫颈鳞状细胞癌（SCC）患者的NK细胞水平和肿瘤大小。本研究是一项采用前后测试、对照组设计的随机实验性临床研究。研究地点：该研究在印度尼西亚东爪哇省泗水市苏托莫医生综合医院妇产科肿瘤妇科进行，时间为2016年2月至2016年5月。临床和组织病理学确诊为IIb - IIIb期（局部晚期）的宫颈SCC患者，所有患者均接受每周50mg/m的顺铂化疗。通过简单随机抽样将患者连续分为2组。对照组仅接受化疗，而治疗组患者在每个化疗周期后还在双侧足三里穴（ST 36）进行1天的电针治疗。主要结局指标为NK细胞百分比和肿瘤大小。在第一次治疗前和第四次治疗后，所有患者均接受外周血检查（全血细胞计数、血清肌酐和血尿素氮水平以及流式细胞术）以确定NK细胞百分比，并进行盆腔磁共振成像以测量宫颈肿瘤大小。次要结局指标为疼痛、恶心、呕吐和食欲。与对照组相比，治疗组NK细胞数量显著增加（P = 0.00），肿瘤大小显著减小（P = 0.03）。与基线相比，治疗组食欲显著增加（P = 0.00），但在疼痛（P = 0.061）、恶心（P = 0.399）和呕吐（P = 0.854）方面无显著差异。IIb - IIIb期宫颈SCC患者接受4个周期的每周50mg/m顺铂化疗并结合电针刺激足三里穴（ST 36）后，外周血NK细胞百分比增加，宫颈肿瘤缩小。
