参芪排毒汤对宫颈癌组织人乳头瘤病毒E6/E7、P53和PRb基因蛋白表达的影响  

Effect and of Shenqi Paidu decoction on the expression of HPV E6/E7,P53 and PRb in cervical cancer tissues

作　　者：郝志晔 张晶[2] 钱伟[1] 卢雯平[1] HAO Zhiye;ZHANG Jing;QIAN Wei;LU Wenping(Department of Oncology,Guang’anmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院肿瘤科,北京100053 [2]深圳市宝安区中医院内分泌科,广东深圳518103

出　　处：《陕西中医》2021年第2期192-195,199,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(8197152667)。

摘　　要：目的:研究参芪排毒汤对宫颈癌组织人乳头瘤病毒(HPV)E6/E7 mRNA、肿瘤抑制基因(P53)、视网膜母细胞瘤蛋白(PRb)表达水平的影响与意义。方法:选取112例宫颈癌患者进入研究,按随机数字表划分成对照组与治疗组,两组均给予新辅助化疗联合腹腔镜宫颈癌根治术治疗,治疗组在新辅助化疗的同时给予参芪排毒汤口服;术前评估两组临床疗效,统计不良反应发生情况,术中取癌旁健康组织与病灶病理组织样本检测HPV E6和E7 mRNA表达水平并计算E6/E7比值,检测样本中P53、PRb表达水平;随访至少3年,比较两组患者的3年无病情进展生存时间(PFS)、总生存时间(OS),分析新辅助化疗后病理组织中HPV E6/E7、P53、PRb表达水平对PFS、OS的预测价值。结果:治疗组缓解率为83.93%,对照组为62.50%,治疗组缓解率高于对照组(P<0.05);治疗组不良反应发生率为12.50%,对照组为17.86%,差异比较无统计学意义(P>0.05);化疗后两组患者癌旁组织中HPV E6/E7比值比较,差异无统计学意义(P>0.05),病理组中HPV E6/E7表达高于治疗组(均P<0.05),两组癌旁与病理组织中P53、PRb比较,差异有统计学意义(均P>0.05);化疗后宫颈癌组织中HPV E6/E7、P53、PRb表达水平对于患者无病情进展生存时间PFS、OS均具有较高预测价值(AUC>0.9,P<0.05);治疗组患者PFS、OS均长于对照组(均P<0.05)。结论:在腹腔镜宫颈癌根治术前新辅助化疗中联合应用参芪排毒汤,能够提高术前疗效,抑制宫颈癌组织中HPV E6/E7表达、提升P53、PRb表达水平,从而起到延长患者无病情进展生存时间与总生存时间,改善预后的作用。Objective:To study the effect of Shenqi Paidu decoction on the expression levels of human papillomavirus(HPV)E6/E7 mRNA,tumor suppressor gene(P53)and retinoblastoma protein(PRb)in cervical cancer tissues.Methods:A total of 112 patients with cervical cancer were selected for the study and divided into the control group and the treatment group according to the random number table.Both groups were given neoadjuvant chemotherapy combined with laparoscopic radical resection of cervical cancer,and patients in the treatment group were given Shenqi Paidu decoction orally at the same time of neoadjuvant chemotherapy.The clinical efficacy of the two groups was evaluated preoperatively,and the occurrence of adverse reactions was counted.The expression levels of HPV E6 and E7 mRNA were detected by taking healthy tissue samples adjacent to the cancer and pathological tissue samples during the operation,and the E6/E7 ratio was calculated,followed by the detection of the expression levels of P53 and PRb in the samples.Furthermore,patients were followed up for at least 3 years,and the 3-year progression-free survival time(PFS)and total survival time(OS)of the two groups were compared to analyze the predictive value of HPV E6/E7,P53 and PRb expression levels in pathological tissues after neoadjuvant chemotherapy for PFS and OS.Results:The remission rate was 83.93%in the treatment group and 62.50%in the conventional group.The remission rate was higher in the treatment group than that in the conventional group(P<0.05).The incidence of adverse reactions was 12.50%in the treatment group and 17.86%in the conventional group,and there was no statistical difference between the two groups(P>0.05).After chemotherapy,there was no statistically significant difference in the ratio of HPV E6/E7 in the paracancerous tissues of the two groups(P>0.05).The expression of HPV E6/E7 in the pathological group was higher than that in the treatment group(P<0.05).There were statistically significant differences in P53 and PRb in the paracancerous and pat

关 键 词：宫颈癌 病理组织 人乳头瘤病毒E6/E7 mRNA 肿瘤抑制基因 视网膜母细胞瘤蛋白 生存函数 

分 类 号：R737.33[医药卫生—肿瘤]