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目的 探讨应用Nd∶YAG激光 ,经纤维喉镜微创治疗喉原位癌 (Tis)和T1期声门癌的疗效及其对机体细胞免疫功能的影响。方法 选择 34例Tis和T1期声带癌患者接受表面麻醉 ,Nd∶YAG激光经纤维喉镜引导 ,对喉肿瘤进行汽化切割治疗。治疗前后应用双抗体夹心ELISA法、3H TdR掺入法和1 2 5 Ⅰ UdR释放法检测患者外周血可溶性白细胞介素 2受体 (SIL 2R) ,白细胞介素 2 (IL 2 )水平和自然杀伤细胞 (NK)活性。结果 34例Tis和T1期声门癌患者中 33例存活。已随访 3～ 7年者 2 7例 ,4例复发 ,治愈率 85 2 %。治疗后嗓音功能均有不同程度的恢复 ,74 1%患者恢复到接近正常 ;SIL 2R水平明显下降 (P <0 0 0 1) ,而IL 2水平和NK活性明显上升 (P <0 0 0 1)。结论 表面麻醉经纤维喉镜Nd∶YAG激光汽化切割治疗 ,对Tis、T1期声门癌和部分喉复发癌疗效好 ,简便 ,安全 ,微创 ,而且对机体细胞免疫功能有较好的促进作用
Objective To investigate the effects of Nd:YAG laser and minimally invasive laryngoscopy on the treatment of laryngeal carcinoma of the larynx (Tis) and stage T1 glottic cancer and their effects on cellular immune function. Methods Totally 34 cases of Tis and T1 stage vocal cord cancer were treated with surface anesthesia. Nd:YAG laser was guided by fiber laryngoscope and the laryngeal tumor was vaporized and cut. Before and after treatment, the levels of soluble interleukin 2 receptor (SIL 2R), interleukin 2 (IL 2) and natural killer (NK) were detected by double antibody sandwich ELISA, 3H TdR incorporation and 125I UdR release assay Cell (NK) activity. Results Of 34 Tis and T1 stage glottic cancer patients, 33 survived. 27 cases were followed up for 3 to 7 years, 4 cases of recurrence, the cure rate was 85 2%. After treatment, the voice function recovered to some extent, 74 1% of the patients returned to near normal level, the level of SIL 2R decreased significantly (P 0 01), and the level of IL 2 and NK activity increased significantly (P 0 01 0 ). Conclusion Surface anesthesia by fiber laryngoscope Nd:YAG laser vaporization cutting treatment of Tis, T1 stage of glottic cancer and some laryngeal recurrence cancer curative effect is simple, safe, minimally invasive, and the body cell immune function better promote