冷冻消融联合索拉非尼和IL-2对晚期转移性肾癌患者外周血细胞因子的影响  

Effects of cryoablation combined with sorafenib and interleukin-2 on cytokines in peripheral blood of patients with advanced metastatic renal cell carcinoma

作　　者：程海峰[1] 赵振民 杨庆民 平玉杰[1] 丁瑞[1] 文红壮[1] 李博科 王磊[1] CHENG Haifeng;ZHAO Zhenmin;YANG Qingmin(Department of Urology Surgery,Central Hospital of Handan City,Hebei,Handan 056001,China)

机构地区：[1]河北省邯郸市中心医院泌尿外1科,056001 [2]河北省邯郸市第七医院外科 [3]河北省曲周县医院外科

出　　处：《河北医药》2018年第6期857-860,共4页Hebei Medical Journal

摘　　要：目的观察冷冻消融联合索拉非尼和IL-2对晚期转移性肾癌患者外周血细胞因子的影响。方法选取晚期转移性肾癌患者90例,随机分为对照组和观察组,每组45例。对照组给予口服索拉非尼和静脉滴注IL-2治疗。治疗组先行局麻下冷冻消融治疗,2周后给予索拉菲尼和IL-2治疗。疗程均为4周。采用Real time-PCR和Western-blot观察2组治疗前后外周血γ-干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)、白介素-6(IL-6)mRNA和蛋白表达水平。采用酶联免疫吸附实验(ELISA)观察2组治疗前后外周血IFN-γ、TNF-α、IL-4、IL-6水平及IFN-γ/IL-4比值变化。结果对照组治疗前后IFN-γ、TNF-α、IL-4、IL-6 mRNA和蛋白表达及IFN-γ/IL-4比值比较差异无统计学意义(P>0.05);观察组治疗后IFN-γ、TNF-αmRNA和蛋白表达及IFN-γ/IL-4比值较治疗前显著升高,IL-6 mRNA和蛋白表达较治疗前显著降低,差异均有统计学意义(P<0.05),IL-4 mRNA和蛋白表达与治疗前比较差异无统计学意义(P>0.05)。结论冷冻消融联合索拉非尼和IL-2治疗晚期转移性肾癌能够明显升高患者外周血IFN-γ、TNF-αmRNA和蛋白表达及IFN-γ/IL-4比值,降低IL-6 mRNA和蛋白表达,从而增强机体免疫功能。Objective To observe the effects of cryoablation combined with sorafenib and interleukin-2 on cytokines in peripheral blood of patients with advanced metastatic renal cell carcinoma.Methods A total of 90 patients with advanced metastatic renal cell carcinoma were randomly divided into observation group(n=45)and control group(n=45).The patients in control group were treated by oral sorafenib tosylate tablets and intravenous drip with recombinant human interleukin-2,however,the patients in observation group were treated by cryoablation under local anesthesia at 2 weeks before being treated with oral sorafenib tosylate tablets and intravenous drip with recombinant human interleukin-2,with a treatment course of 4 weeks for both groups.The expression level of IFN-γ,TNF-α,IL-4,IL-6 mRNA and proteins before and after treatment were detected by Real time-PCR and Western-blot.Moreover the serum levels of IFN-γ,TNF-α,IL-4,IL-6 and ratio of IFN-γ/IL-4 before and after treatment were detected by ELISA and compared between two groups.Results There were no significant differences in the serum levels of IFN-γ,TNF-α,IL-4,IL-6 mRNA and proteins as well as ratio of IFN-γ/IL-4 before and after treatment in control group before and after treatment(P>0.05).As compared with those before treatment,the serum levels of IFN-γ,TNF-αMRNA and proteins and IFN-γ/IL-4 ratio observation group were significantly increased after treatment,however,the levels of IL6 MRNA and proteins were significantly decreased(P<0.05).However there were no significant differences in the levels IL-4 MRNA and proteins in observation group before and after treatment(P>0.05).Conclusion The cryoablation combined with sorafenib and interleukin2 in treatment of advanced metastatic renal cell carcinoma can significantly increase the levels of IFN-γ,TNF-αMRNA and proteins and IFN-γ/IL-4 ratio so as to improve immune function of patients.

关 键 词：冷冻消融 索拉非尼 注射用重组人白细胞介素-2 晚期转移性肾癌 细胞因子 

分 类 号：R737.11[医药卫生—肿瘤]