华蟾素胶囊联合化疗治疗转移性乳腺癌的效果及对免疫功能的影响
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摘要
目的:观察华蟾素胶囊联合TX方案化疗治疗转移性乳腺癌的效果和对免疫功能的影响。方法:回顾性分析2015年6月-2018年9月本院收治的106例乳腺癌患者的临床资料,根据治疗方法不同分为对照组52例和观察组54例。对照组采用多西他赛联合卡培他滨片治疗,观察组在对照组基础上联合华蟾素胶囊治疗。两组患者化疗4个疗程后行影像学检查评价疗效,并在治疗前后抽取两组患者外周血检测细胞因子水平及免疫功能变化。结果:治疗后,观察组DCR、ORR均显著高于对照组(P<0.05)。观察组治疗后血清IL-2水平明显高于治疗前,IL-6水平显著低于治疗前;对照组治疗后血清IL-2水平明显低于治疗前,IL-6水平显著高于治疗前(P<0.05)。观察组治疗后血清IL-2明显高于对照组,而IL-6水平显著低于对照组(P<0.05)。与治疗前比较,观察组治疗后CD3~+、CD4~+、NK细胞水平均明显升高,而CD8+细胞水平显著下降,CD4~+/CD8~+比值显著升高(P<0.05)。对照组治疗后CD3~+、CD4~+、NK细胞水平和CD4~+/CD8~+比值均显著低于观察组,而CD8+水平显著高于观察组(P<0.05)。治疗后,观察组DCR亚组CD4+、NK细胞水平均明显高于对照组的DCR亚组,CD8~+细胞水平明显低于对照组的DCR亚组,差异均有统计学意义(P<0.05)。结论:华蟾素胶囊联合TX方案化疗可有效提高转移性乳腺癌患者的临床效果,增强免疫功能。
Objective:To observe the efficacy of Cinobufotalin Capsules combined with TX regimen in the treatment of metastatic breast cancer(MBC)and its effects on immune function.Method:Clinical data of 106 breast cancer patients admitted to our hospital from June 2015 to September 2018 were retrospectively analyzed,according to different treatment methods,the patients were divided into control group(n=52)and observation group(n=54).The control group was treated with Docetaxel combined with Capecitabine Tablets,and the observation group was treated with Cinobufotalin Capsules on the basis of control group.Imaging examination was performed after 4 courses of chemotherapy in the two groups to evaluate the efficacy,and peripheral blood samples of the two groups were taken before and after treatment to detect cytokine levels and immune function changes.Result:After treatment,DCR and ORR in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the level of serum IL-2 in the observation group was significantly higher than that before treatment,and the level of IL-6 was significantly lower than that before treatment;after treatment,the level of serum IL-2 in the control group was significantly lower than that before treatment,and the level of IL-6 was significantly higher than that before treatment(P<0.05).After treatment,the level of serum IL-2 in the observation group was significantly higher than that in the control group,while the level of IL-6 in the observation group was significantly lower than that in the control group(P<0.05).Compared with before treatment,the levels of CD3+,CD4+,NK cells in the observation group increased significantly after treatment,while the levels of CD8+ decreased significantly,and the ratio of CD4+/CD8+ increased significantly(P<0.05).After treatment,the levels of CD3+,CD4+,NK cells and the ratio of CD4+/CD8+ in the control group were significantly lower than those in the observation group,while the level of CD8+ was significantly higher than that in the observation group(P<0.05).After treatment,the levels of CD4+ and NK cells in the DCR subgroup of the observation group were significantly higher than those in the DCR subgroup of control group,and the level of CD8+ cell was significantly lower than that in the DCR subgroup of control group,with statistically significant differences(P<0.05).Conclusion:Cinobufotalin Capsules combined with TX regimen chemotherapy can effectively improve the clinical efficacy and enhance immune function of patients with MBC.
Objective:To observe the efficacy of Cinobufotalin Capsules combined with TX regimen in the treatment of metastatic breast cancer(MBC)and its effects on immune function.Method:Clinical data of 106 breast cancer patients admitted to our hospital from June 2015 to September 2018 were retrospectively analyzed,according to different treatment methods,the patients were divided into control group(n=52)and observation group(n=54).The control group was treated with Docetaxel combined with Capecitabine Tablets,and the observation group was treated with Cinobufotalin Capsules on the basis of control group.Imaging examination was performed after 4 courses of chemotherapy in the two groups to evaluate the efficacy,and peripheral blood samples of the two groups were taken before and after treatment to detect cytokine levels and immune function changes.Result:After treatment,DCR and ORR in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the level of serum IL-2 in the observation group was significantly higher than that before treatment,and the level of IL-6 was significantly lower than that before treatment;after treatment,the level of serum IL-2 in the control group was significantly lower than that before treatment,and the level of IL-6 was significantly higher than that before treatment(P<0.05).After treatment,the level of serum IL-2 in the observation group was significantly higher than that in the control group,while the level of IL-6 in the observation group was significantly lower than that in the control group(P<0.05).Compared with before treatment,the levels of CD3+,CD4+,NK cells in the observation group increased significantly after treatment,while the levels of CD8+ decreased significantly,and the ratio of CD4+/CD8+ increased significantly(P<0.05).After treatment,the levels of CD3+,CD4+,NK cells and the ratio of CD4+/CD8+ in the control group were significantly lower than those in the observation group,while the level of CD8+ was significantly higher than that in the observation group(P<0.05).After treatment,the levels of CD4+ and NK cells in the DCR subgroup of the observation group were significantly higher than those in the DCR subgroup of control group,and the level of CD8+ cell was significantly lower than that in the DCR subgroup of control group,with statistically significant differences(P<0.05).Conclusion:Cinobufotalin Capsules combined with TX regimen chemotherapy can effectively improve the clinical efficacy and enhance immune function of patients with MBC.
引文
[1]陈万青,李贺,孙可欣,等.2104年中国恶性肿瘤发病和死亡分析[J].中华肿瘤杂志,2108,40(1):5-13.
[2]李贺,郑荣寿,张思维,等.2014年中国女性乳腺癌发病与死亡分析[J].中华肿瘤杂志,2018,40(3):166-170.
[3]Siegel R L,Miller K D,Jemal A.Cancer statistics,2017[J].CACancer J Clin,2017,67(1):7-30.
[4]徐瑞华,姜文奇,管忠震.临床肿瘤内科学[M].北京:人民卫生出版社,2014:264-266.
[5]Kai S,Lu J H,Hui P P,et al.Pre-clinical evaluation of cinobufotalin as a potential anti-lung cancer agent[J].Biochem Biophys Res Commun,2014,452(3):768-774.
[6]徐冬梅,刘丽娟.华蟾素联合卡培他滨治疗老年胃癌的疗效观察[J].实用癌症杂志,2015,30(3):405-407.
[7]陈彬.华蟾素联合GP方案治疗中晚期非小细胞肺癌的临床疗效和抗肿瘤机理[J].实用癌症杂志,2016,31(2):224-227.
[8]东丽,李卉,李刚,等.华蟾素胶囊联合XELOX方案治疗中晚期结直肠癌临床疗效观察[J].海峡药学,2017,29(10):169-171.
[9]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2017年版)[J].中国癌症杂志,2017,27(9):695-720.
[10]Eisenhauer E A,Therasse P,Boqaerts J,et al.New response evaluation criteria in solid tumours:revised RECIST guideline(version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
[11]Wang W H,Xu H Y,Zhao Z M,et al.Dynamic and significant changes of T-cell subgroups in breast cancer patients during surgery and chemotherapy[J].Int Immunopharmacology,2018,65:279-283.
[12]Liu L,Chen F,Zhao J,et al.Correlation between overall survival and other endpoints in metastatic breast cancer with second-or third-line chemotherapy:literature-based analysis of24 randomized trials[J].Bulletin du Cancer,2016,103(4):336-344.
[13]石远凯,巴一,冯继锋,等.中国蒽环类药物特性专家共识[J].中国肿瘤临床,2018,45(3):109-112.
[14]袁梅美,惠起源.华蟾素抗恶性肿瘤的研究进展[J].中国医药导报,2014,11(2):44-46.
[15]Stambrook P J,Maher J,Farzaneh F.Cancer Immunotherapy:Whence and Whither[J].Molecular Cancer Research,2017,15(6):635-650.
[16]Tallerico R,Conti L,Lanzardo S,et al.NK cells control breast cancer and related cancer stem cell hematological spread[J].Oncoimmunology,2017,23,6(3):e1284718.
[17]Chatten C.Immunoregulatory cells of the tumor microenvironment[J].Frontiers in Bioscience,2010,15(1):291-308.
[18]Dethlefsen C,H?jfeldt G,Hojman P.The role of intratumoral and systemic IL-6 in breast cancer[J].Breast Cancer Res Treat,2013,138(3):657-664.
[19]Lin S,Gan Z,Han K,et al.Interleukin-6 as a prognostic marker for breast cancer:a meta-analysis[J].Tumori,2015,101(5):535-541.
[20]陈建英,胡先全,黄三雄,等.华蟾素胶囊联合GP方案对晚期非小细胞肺癌患者免疫功能的影响[J].中国现代医生,2016,54(14):12-15.
[2]李贺,郑荣寿,张思维,等.2014年中国女性乳腺癌发病与死亡分析[J].中华肿瘤杂志,2018,40(3):166-170.
[3]Siegel R L,Miller K D,Jemal A.Cancer statistics,2017[J].CACancer J Clin,2017,67(1):7-30.
[4]徐瑞华,姜文奇,管忠震.临床肿瘤内科学[M].北京:人民卫生出版社,2014:264-266.
[5]Kai S,Lu J H,Hui P P,et al.Pre-clinical evaluation of cinobufotalin as a potential anti-lung cancer agent[J].Biochem Biophys Res Commun,2014,452(3):768-774.
[6]徐冬梅,刘丽娟.华蟾素联合卡培他滨治疗老年胃癌的疗效观察[J].实用癌症杂志,2015,30(3):405-407.
[7]陈彬.华蟾素联合GP方案治疗中晚期非小细胞肺癌的临床疗效和抗肿瘤机理[J].实用癌症杂志,2016,31(2):224-227.
[8]东丽,李卉,李刚,等.华蟾素胶囊联合XELOX方案治疗中晚期结直肠癌临床疗效观察[J].海峡药学,2017,29(10):169-171.
[9]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2017年版)[J].中国癌症杂志,2017,27(9):695-720.
[10]Eisenhauer E A,Therasse P,Boqaerts J,et al.New response evaluation criteria in solid tumours:revised RECIST guideline(version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
[11]Wang W H,Xu H Y,Zhao Z M,et al.Dynamic and significant changes of T-cell subgroups in breast cancer patients during surgery and chemotherapy[J].Int Immunopharmacology,2018,65:279-283.
[12]Liu L,Chen F,Zhao J,et al.Correlation between overall survival and other endpoints in metastatic breast cancer with second-or third-line chemotherapy:literature-based analysis of24 randomized trials[J].Bulletin du Cancer,2016,103(4):336-344.
[13]石远凯,巴一,冯继锋,等.中国蒽环类药物特性专家共识[J].中国肿瘤临床,2018,45(3):109-112.
[14]袁梅美,惠起源.华蟾素抗恶性肿瘤的研究进展[J].中国医药导报,2014,11(2):44-46.
[15]Stambrook P J,Maher J,Farzaneh F.Cancer Immunotherapy:Whence and Whither[J].Molecular Cancer Research,2017,15(6):635-650.
[16]Tallerico R,Conti L,Lanzardo S,et al.NK cells control breast cancer and related cancer stem cell hematological spread[J].Oncoimmunology,2017,23,6(3):e1284718.
[17]Chatten C.Immunoregulatory cells of the tumor microenvironment[J].Frontiers in Bioscience,2010,15(1):291-308.
[18]Dethlefsen C,H?jfeldt G,Hojman P.The role of intratumoral and systemic IL-6 in breast cancer[J].Breast Cancer Res Treat,2013,138(3):657-664.
[19]Lin S,Gan Z,Han K,et al.Interleukin-6 as a prognostic marker for breast cancer:a meta-analysis[J].Tumori,2015,101(5):535-541.
[20]陈建英,胡先全,黄三雄,等.华蟾素胶囊联合GP方案对晚期非小细胞肺癌患者免疫功能的影响[J].中国现代医生,2016,54(14):12-15.