Objective  To investigate the efficacy and immune mechanism of microbiota transplantation and deep hyperthermia in patients with malignant pleural and peritoneal effusion.

Methods  Malignant tumor patients treated at Taizhou Bo’ai Hospital from January 2022 to June 2024, who had pleural and peritoneal effusion were selected. The patients were randomly divided into three groups, the control group only received standard treatment plus fecal microbiota transplantation (FMT), the experimental group received standard treatment plus FMT and hyperthermia, while the placebo group received standard treatment plus simulated intervention. The efficacy of three gourps was evaluated 30 days after treatment. Before and after treatment, changes in T cell subsets, CD4⁺/CD8⁺ ratio, regulatory T cells and natural killer (NK) cells ratio were detected, and cytokine levels such as interleukin (IL)-6, tumor necrosis factor αlpha (TNF-α), IL-2 and IL-10 were detected using multiplex fluorescence immunoassay technology.

Results  The study ultimately included 450 patients, with 150 patients in each group. The experimental group showed significant advantages in the treatment of malignant pleural and peritoneal effusion, and the total complete remission rate increased. After treatment, the experimental group showed significantly higher scores in physiological, psychological, and social functioning than the control group and placebo group. In addition, the experimental group showed significantly higher levels of CD3⁺ T cells, CD4⁺/CD8⁺ ratio, NK cells, Treg cells, and CD8⁺ T cells compared to the control group and placebo group. After treatment, the levels of IL-2 and IL-10 in the experimental group were significantly increased, while the levels of IL-6 and TNF-α were decreased (P<0.05).

Conclusion  The combination of microbiota transplantation and deep hyperthermia shows better clinical efficacy in the treatment of malignant pleural and peritoneal effusion compared to microbiota transplantation alone.

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