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[摘要]
目的:探讨雷公藤甲素(triptolide)对宫颈癌患者免疫功能和肿瘤细胞增殖的作用。方法:选取2015 年7 月至2018 年4 月河北北方学院附属第二医院妇产科收治的62 例宫颈癌患者,通过随机数字法分为观察组和对照组,每组各31 例。两组患者均在腹腔镜手术后接受常规治疗,观察组患者联合雷公藤甲素进行治疗。观察、比较两组患者的疗效、血清免疫细胞和炎症反应因子以及细胞周期蛋白D1(cyclinD1)、雌激素受体α(ERα)水平。结果:观察组宫颈癌患者治疗后的客观缓解率显著高于对照组(87.10% vs 61.29%,P<0.05)。治疗后两组CD3+和CD4+T淋巴细胞以及CD4+/CD8+T淋巴细胞比值均显著升高,观察组显著高于对照组;两组CD8+及PD-L1 T淋巴细胞均显著下降,观察组显著低于对照组(P<0.01)。治疗后,两组患者IL-6、IL-10 以及TNF-α 水平均显著下降,观察组显著低于对照组(P<0.01)。治疗后,两组患者cyclinD1 阳性表达率均显著下降、ERα 阳性表达率均显著升高(均P<0.05);两组间cyclinD1 和ERα 阳性表达率比较差异无统计学意义(均P>0.05)。结论:在常规手术治疗的基础上,雷公藤甲素可有效改善宫颈癌术后患者的免疫功能、降低机体炎症反应、抑制肿瘤细胞的增殖,对宫颈癌具有一定的治疗效果。
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[Abstract]
Objective: To explore the effects of triptolide on immune function and tumor cell proliferation in patients with cervical cancer. Methods: Sixty-two patients with cervical cancer admitted in the Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Hebei North College between July 2015 and April 2018 were randomly divided into the control group (n=31) and the observation group (n=31). All patients received routine treatment after laparoscopy, while those in the observation group received additional triptolide. The treatment efficacy, serum immune cells, inflammatory factors and the levels of cyclinD1, estrogen receptor α (ERα ) were observed and compared between the two groups. Results: The total remission rate of the patients in the observation group was 87.10%, significantly higher than 61.29% in the control group (P<0.05). After treatment, the levels of CD3+ and CD4+ T lymphocytes and CD4+/CD8+ T lymphocytes in the two groups increased significantly, with more obvious increase in the observation group than that in the control group (P<0.01). The levels of CD8+ and programmed cell death-ligand 1 (PD-L1) T lymphocytes in the two groups decreased significantly after treatment, with a more obvious decrease in observation group than that in control group (P<0.01). After treatment, the levels of interleukin-6 (IL-6), IL-10 and tumor necrosis factor-α (TNF-α) in the two groups decreased,and those in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the positive expression rate of cyclinD1 decreased and the positive expression rate of ER α increased in both groups (all P<0.05), with no significant difference between the two groups (all P>0.05). Conclusion: On the basis of routine surgical treatment, triptolide can effectively improve the immune function, reduce the inflammatory response, inhibit the proliferation of tumor cells and regulate the expression of cancer-related factors in patients with cervical cancer, which has a certain therapeutic effect on cervical cancer.
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