5A护理模式对原发性肝癌患者射波刀治疗后免疫平衡及淋巴结转移的影响
Impact of the 5A nursing model on immune balance and lymph node metastasis in primary liver cancer patients post-CyberKnife treatment.
作者信息
Su Xin, Li Xiuli, Zhang Juan, Fang Haixian, Zhang Liwei, He Li
机构信息
Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
出版信息
BMC Cancer. 2025 Jul 1;25(1):1024. doi: 10.1186/s12885-025-14208-7.
OBJECTIVE
The study aimed to investigate the impact of the 5A nursing model on immune status, lymph node metastasis, and survival in patients with primary liver cancer following CyberKnife treatment.
METHODS
A total of 80 patients diagnosed with primary liver cancer and admitted to the Oncology Department of our hospital between February and December 2023 were enrolled. All patients underwent tissue biopsy confirmation and were scheduled to receive CyberKnife treatment. Patients were randomly assigned to either the 5A nursing group or the conventional nursing group, with 40 patients in each group. Written consent was obtained from all participants upon enrollment. Baseline data for both groups were recorded. Tumor tissue immune cell infiltration was assessed using flow cytometry. Levels of IL-2, IL-10, and TNF-α cytokines in serum were measured via ELISA. Lymph node metastasis occurrence was compared between groups during follow-up. Patient quality of life was evaluated using the EORTC QLQ-C30 survey. Progression-free survival (PFS) and OS were assessed and compared between groups.
RESULTS
Baseline characteristics, including age, gender, pathological stage, lymph node metastasis, and underlying disease, were similar between the two groups (P > 0.05). In the 5A nursing group, concentrations of CD8 + T cells and NK cells were higher compared to the conventional nursing group (P < 0.05), whereas Tregs cell concentration was lower in the 5A nursing group than that in the conventional nursing group (P < 0.05). Levels of IL-2 and TNF-α were elevated in the 5A nursing group compared to those in the conventional nursing group (P < 0.05), while IL-10 levels were decreased in the 5A nursing group (P < 0.05). During the initial 6 months, the rate of lymph node metastasis did not significantly differ between the two groups (P > 0.05). However, at the 12th and 18th months, lymph node metastasis incidence was lower in the 5A nursing group compared to the conventional nursing group (P < 0.05). The 5A nursing group also demonstrated higher quality of life scores compared to the conventional nursing group (P < 0.05). PFS and OS were significantly longer in the 5A nursing group compared to the conventional nursing group (P < 0.05).
CONCLUSION
The 5A nursing model significantly impacts immune balance and reduces lymph node metastasis in primary liver cancer patients following CyberKnife treatment. This model enhances CD8 + T cell and NK cell concentrations while reducing Tregs cells, thereby promoting a stronger anti-tumor immune response and ultimately decreasing the rate of lymph node metastasis.
目的
本研究旨在探讨5A护理模式对接受射波刀治疗的原发性肝癌患者免疫状态、淋巴结转移及生存情况的影响。
方法
选取2023年2月至12月期间我院肿瘤科收治的80例原发性肝癌患者。所有患者均经组织活检确诊，并计划接受射波刀治疗。将患者随机分为5A护理组和常规护理组，每组40例。所有参与者在入组时均签署了书面知情同意书。记录两组的基线数据。采用流式细胞术评估肿瘤组织免疫细胞浸润情况。通过酶联免疫吸附测定法检测血清中白细胞介素-2（IL-2）、白细胞介素-10（IL-10）和肿瘤坏死因子-α（TNF-α）细胞因子的水平。随访期间比较两组淋巴结转移的发生情况。采用欧洲癌症研究与治疗组织生活质量问卷核心30项（EORTC QLQ-C30）调查评估患者的生活质量。评估并比较两组的无进展生存期（PFS）和总生存期（OS）。
结果
两组的基线特征，包括年龄、性别、病理分期、淋巴结转移及基础疾病等方面相似（P＞0.05）。5A护理组中，CD8⁺T细胞和自然杀伤细胞（NK细胞）的浓度高于常规护理组（P＜0.05），而5A护理组调节性T细胞（Tregs细胞）浓度低于常规护理组（P＜0.05）。与常规护理组相比，5A护理组中IL-2和TNF-α水平升高（P＜0.05），而5A护理组中IL-10水平降低（P＜0.05）。在最初6个月期间，两组间淋巴结转移率无显著差异（P＞0.05）。然而，在第12个月和第18个月时，5A护理组的淋巴结转移发生率低于常规护理组（P＜0.05）。5A护理组的生活质量评分也高于常规护理组（P＜0.05）。与常规护理组相比，5A护理组的PFS和OS显著更长（P＜0.05）。
结论
5A护理模式对接受射波刀治疗的原发性肝癌患者的免疫平衡有显著影响，并可减少淋巴结转移。该模式可提高CD8⁺T细胞和NK细胞浓度，同时减少Tregs细胞，从而促进更强的抗肿瘤免疫反应，最终降低淋巴结转移率。
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