化瘀解毒法通过调控PAR1对非小细胞肺癌靶向治疗患者免疫逃逸的逆转  

Effect and Mechanism of Resolving Stasis and Detoxication Method Combined with EGFR-TKI on NSCLC Based on Modulating PAR1 to Remodel Immune Surveillance

作　　者：李燕 蒋立峰 马东阳 崔庆丽 胡彦辉 付槟梵 LI Yan;JIANG Lifeng;MA Dongyang;CUI Qingli;HU Yanhui;FU Binfan(The Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,Henan,China)

机构地区：[1]郑州大学附属肿瘤医院,河南郑州450008

出　　处：《辽宁中医杂志》2020年第6期145-147,I0002,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金联合基金(U1704181)。

摘　　要：目的观察探究化瘀解毒法对靶向治疗的非小细胞肺癌(NSCLC)患者肿瘤龛中PAR1表达的调控和对患者免疫逃逸的逆转作用。方法将靶向药物治疗中的78例NSCLC患者随机分为对照组(39例)和观察组(39例)。对照组仅给予靶向治疗,观察组在靶向治疗基础上口服血府逐瘀汤加减方,30 d为1个疗程。2个疗程后采用免疫组化法检测肿瘤龛中PAR1表达,流式细胞术检测免疫功能变化,并对临床疗效进行评价。结果治疗后观察组肿瘤龛中PAR1表达明显下调(P<0.05),但与正常组织中PAR1表达仍存在差异;而对照组较前变化不大(P>0.05)。治疗后,两组的免疫功能均有所恢复,观察组治疗后T细胞总数及亚群的逆转幅度更为明显,且差异具有统计学意义(P<0.05)。与对照组相比,观察组的有效率和控制率均有明显提高(P<0.05)。结论化瘀解毒法对于靶向治疗的NSCLC患者具有增加疗效的作用,其通过调节肿瘤龛中PAR1因子表达,改善相关免疫微环境,逆转免疫逃逸可能是其发挥作用的主要机制。Objective To observe the effect and mechanism of resolving stasis and detoxication method combined with EGFR-TKI on NSCLC based on modulating PAR1 to remodel immune surveillance.Methods Seventy-eight NSCLC patients treated with EGFR-TKI were randomly divided into two groups.The control group included 39 cases which were treated with EGFR-TKI onlyand the treatment group included the other 39 cases which were treated with Xiaochaihu Decoction combined with the same chemotherapy.Both were 30 days for a course.After 2 courses,immunohistochemistry method was used to study PAR1 expression of tumor tissue.Immune function was detected by Flow cytometer,and the effectiveness was valued as well.Results After treatment,PAR1 expression was remarkably down-regulated in the treatment group(P<0.05).There was no obvious change in control group(P>0.05).The immune function was improved in both groups.The increase of total T cell and subgroup in treatment group were more obvious(P<0.05).The effective rate and improvement of the treatment group were higher than those of the control group(P<0.05).Conclusion The regime of resolving stasis and detoxication method can improve the efficacy on NSCLC treated with EGFR-TKI.One of the possible mechanisms is regulation of PAR1 expression in tumor tissue to remodel immune surveillance.

关 键 词：化瘀解毒法 NSCLC PAR1 免疫逃逸 

分 类 号：R734.2[医药卫生—肿瘤]