Huan Mei, Tian Wei, Zhang Zhixia
Operating Room, Linyi Cancer Hospital, Linyi, Shandong 276000, P.R. China.
Outpatient Department, Linyi Cancer Hospital, Linyi, Shandong 276000, P.R. China.
Exp Ther Med. 2020 Dec;20(6):277. doi: 10.3892/etm.2020.9407. Epub 2020 Oct 27.
The aim of the present study was to investigate the efficacy and prognosis of surgical treatment in anorectal malignant melanoma (ARMM) as well as its effects on immune and inflammatory profiles. A total of 64 patients with ARMM were enrolled and divided into control group (n=32) and observation group (n=32) based on different therapeutic methods. Patients in the observation group underwent wide local excision, while those in the control group were given non-surgical treatment. The immune function was compared between the two groups after treatment. The expression levels of serum IL-17, IL-23 and vascular endothelial growth factor (VEGF) were compared between the groups before and after treatment. Patients were followed up for 5 years to observe the recurrence and survival rates in the two groups. Compared with those in the control group, the levels of cluster of differentiation (CD)3, CD4 and CD4/CD8 were increased, while the level of CD8 was reduced in the observation group (P<0.05). The levels of serum IL-17, IL-23 and VEGF were significantly lower in both groups at 4, 6 and 8 weeks after treatment than those before treatment, and the decrease was more obvious in the observation group (P<0.05). The observation group exhibited a notably elevated 5-year survival rate and a remarkably decreased recurrence rate in comparison with the control group (P<0.05). For ARMM, surgical treatment is more effective than non-surgical treatment, which has less effect on immune function, is able to reduce serum IL-17, IL-23 and VEGF levels, lower recurrence rate, improve patient survival rate, and plays a certain positive role in prolonging the survival time of ARMM patients.
本研究旨在探讨手术治疗在肛管直肠恶性黑色素瘤（ARMM）中的疗效和预后及其对免疫和炎症指标的影响。共纳入64例ARMM患者，根据不同治疗方法分为对照组（n = 32）和观察组（n = 32）。观察组患者接受广泛局部切除，而对照组患者接受非手术治疗。治疗后比较两组的免疫功能。比较两组治疗前后血清白细胞介素-17（IL-17）、白细胞介素-23（IL-23）和血管内皮生长因子（VEGF）的表达水平。对患者进行5年随访，观察两组的复发率和生存率。与对照组相比，观察组分化簇（CD）3、CD4水平及CD4/CD8比值升高，CD8水平降低（P<0.05）。治疗后4、6、8周两组血清IL-17、IL-23和VEGF水平均显著低于治疗前，且观察组下降更明显（P<0.05）。与对照组相比，观察组5年生存率显著提高，复发率显著降低（P<0.05）。对于ARMM，手术治疗比非手术治疗更有效，对免疫功能影响较小，能够降低血清IL-17、IL-23和VEGF水平，降低复发率，提高患者生存率，对延长ARMM患者的生存时间具有一定的积极作用。
