同步放化疗并行免疫维持治疗在晚期宫颈癌患者中的潜在作用分析  

Analysis of the potential role of chemoradiotherapy and immune maintenance therapy in patients with advanced cervical cancer

作　　者：张亚慧 张荣[1] 贾素红[1] 郭亮生[1] 张金婷 Zhang Yahui;Zhang Rong;Jia Suhong;Guo Liangsheng;Zhang Jinting(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Soochow University,Suzhou Jiangsu 215004,P.R.China)

机构地区：[1]苏州大学附属第二医院妇产科,江苏苏州215004

出　　处：《中国计划生育和妇产科》2024年第6期103-108,共6页Chinese Journal of Family Planning & Gynecotokology

基　　金：苏州大学附属第二医院优势学科托举项目(项目编号:XKTJ-XK202006)。

摘　　要：目的 探究同步放化疗并行免疫维持治疗对晚期宫颈癌患者的疗效及对宫颈癌人子宫颈鳞癌细胞(SiHa)恶性逆转作用。方法 选取2020年4月至2021年8月苏州大学附属第二医院晚期宫颈癌患者110例,治疗过程中脱落4例,最后计入106例,按照随机数字表法分为两组,每组53例。对照组采取同步放化疗治疗,观察组采取同步放化疗+免疫维持治疗,观察两组临床疗效、治疗前后肿瘤标志物[糖类抗原199(CA199)、糖类抗原125(CA125)、骨桥蛋白(OPN)]、血管生成因子[转化生长因子-β1(TGF-β1)、血管内皮细胞生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)]、宫颈癌SiHa细胞生物学行为、生存情况及毒副反应发生率。结果 观察组总有效率(64.15%)高于对照组(41.51%);治疗2周、6周后,观察组血清CA125、CA199、OPN水平,血清TGF-β1、VEGF、bFGF水平,E6、E7蛋白表达量,微小核糖核酸(miR)-29、miR-101表达量低于对照组;p53蛋白表达量高于对照组(P均<0.05);随访24个月,观察组疾病进展风险、疾病死亡风险均低于对照组(P<0.05);治疗期间,两组毒副反应发生率相比,差异无统计学意义(P>0.05)。结论 同步放化疗并行免疫维持治疗可强化抗肿瘤效果,降低肿瘤标志物水平,抑制肿瘤血管生成,并对宫颈癌SiHa细胞恶性逆转、预后改善具有积极作用。Objective To explore the efficacy of chemoradiotherapy combined with immune maintenance in the treatment of advanced cervical cancer and the reversal of malignant cervical squamous cell carcinoma(SiHa).Methods 110 cases of advanced cervical cancer patients in the Second Affiliated Hospital of Soochow University from April 2020 to August 2021 were selected,4 cases were dislodged during treatment,and 106 cases were finally counted,which were divided into two groups according to the randomized numerical table method,with 53 cases in each group.The control group was treated with concurrent chemoradiotherapy,and the observation group was treated with concurrent chemoradiotherapy combined with immune maintenance.Observed the clinical efficacy of the two groups,as well as tumor markers[carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125),osteopontin(OPN)],angiogenic factors[transforming growth factor-β1(TGF-β1),vascular endothelial cell growth factor(VEGF),basic fibroblast growth factor(bFGF)],biological behavior of cervical cancer SiHa cells before and after treatment,and the survival and incidence of toxic side effects were also compared between the two groups.Results The total effective rate of observation group was(64.15%)which was higher than that of control group(41.51%).After 2 and 6 weeks of treatment,the levels of serum CA125,CA199,OPN,TGF-β1,VEGF and bFGF,the expression of E6 and E7 protein,and miR-29、miR-101 in observation group were lower than those in control group,and the expression of p53 protein was higher than that in control group(P<0.05).After 24 months of follow-up,the risk of disease progression and death in the observation group were lower than those in the control group(P<0.05).During the treatment period,there was no statistically significant difference in the incidence of toxic side effects compared to the two groups(P>0.05).Conclusion Concurrent chemoradiotherapy and immunomaintenance therapy can strengthen the anti-tumor effect,reduce the level of tumor markers,inhibit tumor an

关 键 词：宫颈癌 晚期 放化疗 免疫维持治疗 SIHA细胞 

分 类 号：R737.33[医药卫生—肿瘤]