ObjectiveTo investigate the short-term curative efficacy of DC-CIK in comprehensive therapy of esophagus cancer. MethodsWe randomly allocated 52 patients with esophagus cancer who had preoperatively confirmed by CT on stage Ⅱ-Ⅲ B into an observation group and a control group with 26 patients in each group. There were 14 male and 12 female patients in the observation group at median age of 60 years (range:49-67 years). There were 16 male and 10 female patients in the control group with median age of 62 years (range:48-65 years).The control group received postoperative chemotherapy, and the observation group received postoperative chemotherapy combined with DC-CIK biotherapy. The combination of paclitaxel and cisplatin for four cycles was choosen as the chemotherapy regimen. Patients in the observation group were treated with DC-CIK biotherapy for 2 weeks after operation. At the fifth week they received the first cycle of chemotherapy. There was a course of biotherapy between two cycles of chemotherapy. The clinical efficacy, lymphocyte subtypes, and intracellular cytokines in peripheral blood of the patients, performance status (KPS) and adverse reactions were compared. ResultsAll patients completed the therapy regimen successfully. In the observation group, the ratios of CD3+, CD4+, CD4+/CD8+, CD56+, and CD19+ increased, and the ratio of CD8+ decreased with significant differences (P<0.05).The biotherapy significantly increased interleukin 2 (IL-2), IL-12, interferon gamma (IFN-γ) and tumor necrosis fator (TNF)-α level (P<0.05). However, in the control group, there was no significant difference between post and pre-therapy in the levels of lymphocytes and cytokines. The effective rate of KPS was 76.92% in the observation group and 46.15% in the control group with a significant difference (P=0.023). No other adverse reactions except 3 patients with fever in the observation group were found. ConclusionThe short-term curative efficacy of DC-CIK in comprehensive therapy of esophagus cancer is distinct. DC-CIK biotherapy can improve patients' immune functions and elevate their life quality, so it is likely to be an effective adoptive immunotherapy for esophagus cancer.
Objective To evaluate the characteristics and reasons of complications in the patients with thoracoscopic esophagectomy. Methods We retrospectively analyzed the clinical data of 165 patients with thoracoscopic esophagectomy in our hospital from January 2013 through January 2015. There were 102 males and 63 females at average age of 67.9±8.3 years. Results The operation time was 275.3±50.2 min. The intraoperative blood loss was 230.0±110.5 ml. The number of lymph node dissection was 18.1±6.5. The volume of drainage in thoracic cavity was 750±550 ml on the third day after operation. Thoracoscopic esophagectomy surgeries were successful except that 13 patients (7.8%) converted to open operation including 6 patients (4.2%) with severe pleural adhesion, 2 patients (1.2%) with hemorrhage, 2 patients (1.2%) with arrhythmia, and 3 patients (1.8%) with abnormal oxygenation. There were 17 patients (10.8%) were with intraoperative complications including 2 patients (1.2%) with arrhythmia, 3 patients (1.8%) with abnormal oxygenation, 7 patients (4.2%) with hemorrhage caused by vascular injury, 4 patients (2.4%) with thoracic duct injury, 1 patient (0.6%) with recurrent laryngeal nerve injury. Moreover, 46 patients (27.8%) experienced postoperative complications including 23 patients (13.9%) with pulmonary infection, 6 patients (3.6%) with hoarseness, 4 patients (2.4%) with anastomotic leakage, 3 patients (1.8%) with incision infection, 2 patients (1.2%) with tracheoesophageal fistula, and 2 patients (1.2%) with pneumothorax. Unexpectedly, five patients underwent re-operation due to chylothorax (n=3, 1.8%) and hemorrhage (n=2, 1.2%). One patient (0.06%) died of acute pulmonary embolism. Conclusion Serious adhesion in abdominal cavity, abnormal of lung and heart. And bleeding are the main reasons caused transferring open thoracic surgery operation in patients with thoracoscopic esophagectomy. Lung infection, hoarseness, and anastomotic leakage of neck are the most common postoperative complications. And acute pulmonary embolism is the main cause of postoperative death. Proper precautions to decrease the morbidity of complication are necessary.