调强放疗治疗宫颈癌患者对血清MMP-9的影响分析
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摘要
目的 :探讨调强放疗治疗宫颈癌患者对血清基质金属蛋白酶-9(MMP-9)的影响。方法 :2015年2月～2017年8月选择在我院诊治的宫颈癌患者88例,根据治疗方法的不同分为实验组48例与对照组40例,对照组给予三维适形放疗,实验组给予调强放疗,两组都放疗观察3个月,记录血清MMP-9变化情况。结果 :治疗后实验组与对照组的总有效率分别为79.2%和35.0%,实验组显著高于对照组。治疗期间实验组的3度以上骨髓抑制、放射性膀胱炎、放射性直肠炎等不良反应发生率为6.3%,对照组为40.0%,实验组显著低于对照组。实验组与对照组治疗后的血清MMP-9水平都显著低于治疗前,实验组也显著低于对照组。随访至今,实验组的总生存时间与无瘤生存时间都显著长于对照组。结论 :调强放疗治疗宫颈癌能降低血清MMP-9的表达,减少放疗不良反应的发生,提高治疗效果,延长患者的生存时间,有很好的应用效果。
Objective To investigate the effects of intensity modulated radiation therapy on serum matrix metalloproteinase-9(MMP-9) in patients with cervical cancer. Methods From February 2015 to August 2017, 88 cases of cervical cancer were selected in our hospital and weer divided into the 48 cases in the experimental group and 40 cases in the control group accorded to the different treatment methods. The control group were given traditional radiotherapy, the experimental group were given intensity modulated radiotherapy, and the two groups were treated with radiotherapy for 3 months, and the changes of serum MMP-9 were recorded. Results After treatment, the total effective rates of the experimental group and the control group were 79.2% and 35% respectively, and the experimental group were significantly higher than that of the control group. During the treatment, the incidence of adverse reactions such as myelosuppression, radiation cystitis and radiation proctitis in the experimental group was 6.3%, and that in the control group was 40.0%. The experimental group was significantly lower than the control group. The serum MMP-9 levels of the experimental group and the control group after treatment were significantly lower than that before treatment, and the experimental group were also significantly lower than that of the control group. Up to now,the total survival time and tumor free survival time of the experimental group were significantly higher than those of the control group. Conclusion Intensity-modulated radiotherapy for cervical cancer can reduce the expression of serum MMP-9, reduce the occurrence of adverse reactions of radiotherapy, improve the therapeutic effect, prolong the survival time of patients, and have a good application effect.
Objective To investigate the effects of intensity modulated radiation therapy on serum matrix metalloproteinase-9(MMP-9) in patients with cervical cancer. Methods From February 2015 to August 2017, 88 cases of cervical cancer were selected in our hospital and weer divided into the 48 cases in the experimental group and 40 cases in the control group accorded to the different treatment methods. The control group were given traditional radiotherapy, the experimental group were given intensity modulated radiotherapy, and the two groups were treated with radiotherapy for 3 months, and the changes of serum MMP-9 were recorded. Results After treatment, the total effective rates of the experimental group and the control group were 79.2% and 35% respectively, and the experimental group were significantly higher than that of the control group. During the treatment, the incidence of adverse reactions such as myelosuppression, radiation cystitis and radiation proctitis in the experimental group was 6.3%, and that in the control group was 40.0%. The experimental group was significantly lower than the control group. The serum MMP-9 levels of the experimental group and the control group after treatment were significantly lower than that before treatment, and the experimental group were also significantly lower than that of the control group. Up to now,the total survival time and tumor free survival time of the experimental group were significantly higher than those of the control group. Conclusion Intensity-modulated radiotherapy for cervical cancer can reduce the expression of serum MMP-9, reduce the occurrence of adverse reactions of radiotherapy, improve the therapeutic effect, prolong the survival time of patients, and have a good application effect.
引文
[1]周杰,曾志英,黄美荣,等.地佐辛超前镇痛对宫颈癌根治术患者的临床价值[J].湖南师范大学学报(医学版), 2015, 12(3):23-25.
[2]金虹,张萌,刘念,李珊. miR-30c抑制宫颈癌细胞恶性表型的分子机制研究[J].中国病理生理杂志, 2018, 34(5):804-811.
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[5]Chen AM, Yoshizaki T, Wang PC, et al. Hazards of sparing the ipsilateral parotid gland in the node-positive neck with intensity modulated radiation therapy:Spatial analysis of regional recurrence risk[J]. Adv Radiat Oncol, 2017, 3(2):111-120.
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[7]常海平,宋淑芳,郑健.过表达TPX2对人宫颈癌HeLa细胞侵袭和凋亡的影响[J].第三军医大学学报, 2018, 40(3):216-221.
[8]Li Y, Ou X, Shen C, et al. Patterns of local failures and suggestions for reduction of clinical target volume for nasopharyngeal carcinoma patients without cervical lymph node metastasis[J]. Onco Targets Ther,2018, 7(11):2545-2555.
[9]Ferrandina G, Palluzzi E, Gallotta V, et al. Neo-adjuvant platinumbased chemotherapy followed by chemoradiation and radical surgery in locally advanced cervical cancer(Lacc)patients:A phase II study[J].Eur J Surg Oncol, 2018, 44(7):1062-1068.
[10]肖黎,张水蓉,胡萍,等. miRNA-31靶向基质金属蛋白酶-3基因对宫颈鳞癌侵袭力的影响[J].中国老年学杂志, 2018, 38(9):2210-2212.
[11]沈浩明,杨友义,吴白平,等. MMP-9和TGFβ1在宫颈鳞癌中的表达和意义[J].湖南师范大学学报(医学版), 2015, 12(6):1-6.
[12] Ito M, Shimizu H, Aoyama T, et al. Efficacy of virtual block objects in reducing the lung dose in helical tomotherapy planning for cervical oesophageal cancer:a planning study[J]. Radiat Oncol, 2018, 13(1):62.
[13]李颖,王瑚. KiSS1蛋白和MMP-2在宫颈癌组织中的表达及诊断价值[J].中国实验诊断学, 2018, 22(3):460-461.
[14] Ramey SJ, Asher D, Kwon D, et al. Delays in definitive cervical cancer treatment:An analysis of disparities and overall survival impact[J]. Gynecol Oncol, 2018, 149(1):53-62.
[15]殷敏敏,罗英华.宫颈癌组织中VEGF、MMP-9表达与微血管密度的关系[J].解放军预防医学杂志, 2017, 35(5):461-464.
[16] Espenel S, Garcia MA, Trone JC, et al. From IB2 to IIIB locally advanced cervical cancers:report of a ten-year experience[J]. Radiat Oncol, 2018, 13(1):16.
[17] Liu YM, Ni LQ, Wang SS, et al. Outcome and prognostic factors in cervical cancer patients treated with surgery and concurrent chemoradiotherapy:a retrospective study[J]. World J Surg Oncol, 2018, 16(1):18.
[18]刘玉娜,贺鹏,韩文红,等. TP新辅助化疗联合腹腔镜术对局部晚期宫颈癌患者分子标志物及免疫功能的影响[J].海南医学院学报,2017, 23(19):2728-2731.
[19] Tho D, Racine E, Easton H, et al. Technical Note:On EM reconstruction of a multi channel shielded applicator for cervical cancer brachytherapy:A feasibility study[J]. Med Phys, 2018, 45(4):1673-1676.
[20]冯春翠,徐伏兰,周琦.血清及组织IGF及MMP相关指标对宫颈癌的检测意义[J].实用癌症杂志, 2017, 32(10):1603-1605.
[21] Guo M, Huang E, Liu X, et al. Volumetric Modulated Arc Therapy versus Fixed-Field Intensity-Modulated Radiotherapy in Radical Irradiation for Cervical Cancer without Lymphadenectasis:Dosimetric and Clinical Results[J]. Oncol Res Treat, 2018, 41(3):105-109.
[22]卢建军,宋建东,杨鹏霞,等.人乳头状瘤病毒感染对宫颈上皮内瘤变及宫颈癌患者组蛋白去乙酰化酶1及基质金属蛋白酶表达的影响研究[J].中华医院感染学杂志, 2017, 27(4):884-887.
[23] O Donnell B, Shiao JC, Pezzi TA, et al. Stereotactic Body Radiation Therapy, Intensity-Modulated Radiation Therapy, and Brachytherapy Boost Modalities in Invasive Cervical Cancer:A Study of the National Cancer Data Base[J]. Int J Gynecol Cancer, 2018, 28(3):563-574.
[24] Peyraga G, Caron D, Lizee T, et al. Digestive toxicities after palliative three-dimensional conformal radiation therapy(3D-CRT)for cervicothoracic spinal metastases[J]. Support Care Cancer, 2018, 26(6):1897-1903.
[25]朱来芳.宫颈分泌物中p16、MMPs表达量与宫颈癌组织中血管新生、细胞增殖的相关性[J].海南医学院学报, 2017, 23(8):1117-1119, 1123.
[2]金虹,张萌,刘念,李珊. miR-30c抑制宫颈癌细胞恶性表型的分子机制研究[J].中国病理生理杂志, 2018, 34(5):804-811.
[3]Kang M, Zhou P, Wei T, et al. A novel N staging system for NPC based on IMRT and RTOG guidelines for lymph node levels:Results of a prospective multicentric clinical study[J]. Oncol Lett, 2018, 16(1):308-316.
[4]封菊,苑中甫,邱海峰. RNA干扰FAK表达抑制宫颈癌细胞侵袭、迁移能力的研究[J].癌症进展, 2018, 16(2):179-182.
[5]Chen AM, Yoshizaki T, Wang PC, et al. Hazards of sparing the ipsilateral parotid gland in the node-positive neck with intensity modulated radiation therapy:Spatial analysis of regional recurrence risk[J]. Adv Radiat Oncol, 2017, 3(2):111-120.
[6]Murrell DH, Warner A, Benwell Q, et al. Image-guided radiation therapy for post-operative gynaecologic cancer:patient set up verification with and without implanted fiducial markers[J]. Acta Oncol, 2018,6(18):1-6.
[7]常海平,宋淑芳,郑健.过表达TPX2对人宫颈癌HeLa细胞侵袭和凋亡的影响[J].第三军医大学学报, 2018, 40(3):216-221.
[8]Li Y, Ou X, Shen C, et al. Patterns of local failures and suggestions for reduction of clinical target volume for nasopharyngeal carcinoma patients without cervical lymph node metastasis[J]. Onco Targets Ther,2018, 7(11):2545-2555.
[9]Ferrandina G, Palluzzi E, Gallotta V, et al. Neo-adjuvant platinumbased chemotherapy followed by chemoradiation and radical surgery in locally advanced cervical cancer(Lacc)patients:A phase II study[J].Eur J Surg Oncol, 2018, 44(7):1062-1068.
[10]肖黎,张水蓉,胡萍,等. miRNA-31靶向基质金属蛋白酶-3基因对宫颈鳞癌侵袭力的影响[J].中国老年学杂志, 2018, 38(9):2210-2212.
[11]沈浩明,杨友义,吴白平,等. MMP-9和TGFβ1在宫颈鳞癌中的表达和意义[J].湖南师范大学学报(医学版), 2015, 12(6):1-6.
[12] Ito M, Shimizu H, Aoyama T, et al. Efficacy of virtual block objects in reducing the lung dose in helical tomotherapy planning for cervical oesophageal cancer:a planning study[J]. Radiat Oncol, 2018, 13(1):62.
[13]李颖,王瑚. KiSS1蛋白和MMP-2在宫颈癌组织中的表达及诊断价值[J].中国实验诊断学, 2018, 22(3):460-461.
[14] Ramey SJ, Asher D, Kwon D, et al. Delays in definitive cervical cancer treatment:An analysis of disparities and overall survival impact[J]. Gynecol Oncol, 2018, 149(1):53-62.
[15]殷敏敏,罗英华.宫颈癌组织中VEGF、MMP-9表达与微血管密度的关系[J].解放军预防医学杂志, 2017, 35(5):461-464.
[16] Espenel S, Garcia MA, Trone JC, et al. From IB2 to IIIB locally advanced cervical cancers:report of a ten-year experience[J]. Radiat Oncol, 2018, 13(1):16.
[17] Liu YM, Ni LQ, Wang SS, et al. Outcome and prognostic factors in cervical cancer patients treated with surgery and concurrent chemoradiotherapy:a retrospective study[J]. World J Surg Oncol, 2018, 16(1):18.
[18]刘玉娜,贺鹏,韩文红,等. TP新辅助化疗联合腹腔镜术对局部晚期宫颈癌患者分子标志物及免疫功能的影响[J].海南医学院学报,2017, 23(19):2728-2731.
[19] Tho D, Racine E, Easton H, et al. Technical Note:On EM reconstruction of a multi channel shielded applicator for cervical cancer brachytherapy:A feasibility study[J]. Med Phys, 2018, 45(4):1673-1676.
[20]冯春翠,徐伏兰,周琦.血清及组织IGF及MMP相关指标对宫颈癌的检测意义[J].实用癌症杂志, 2017, 32(10):1603-1605.
[21] Guo M, Huang E, Liu X, et al. Volumetric Modulated Arc Therapy versus Fixed-Field Intensity-Modulated Radiotherapy in Radical Irradiation for Cervical Cancer without Lymphadenectasis:Dosimetric and Clinical Results[J]. Oncol Res Treat, 2018, 41(3):105-109.
[22]卢建军,宋建东,杨鹏霞,等.人乳头状瘤病毒感染对宫颈上皮内瘤变及宫颈癌患者组蛋白去乙酰化酶1及基质金属蛋白酶表达的影响研究[J].中华医院感染学杂志, 2017, 27(4):884-887.
[23] O Donnell B, Shiao JC, Pezzi TA, et al. Stereotactic Body Radiation Therapy, Intensity-Modulated Radiation Therapy, and Brachytherapy Boost Modalities in Invasive Cervical Cancer:A Study of the National Cancer Data Base[J]. Int J Gynecol Cancer, 2018, 28(3):563-574.
[24] Peyraga G, Caron D, Lizee T, et al. Digestive toxicities after palliative three-dimensional conformal radiation therapy(3D-CRT)for cervicothoracic spinal metastases[J]. Support Care Cancer, 2018, 26(6):1897-1903.
[25]朱来芳.宫颈分泌物中p16、MMPs表达量与宫颈癌组织中血管新生、细胞增殖的相关性[J].海南医学院学报, 2017, 23(8):1117-1119, 1123.