榄香烯口服乳联合DO化疗方案对食管癌患者血清miR-203、miR-21水平的影响 (1).pdf

承 德 医 学 院 学 报JOURNAL OF CHENGDE MEDICAL UNIVERSITY208Vol.40 No.3 2023价颈动脉斑块内新生血管的比较J.中国超声医学杂志，2019，3（12）：1066-1069.朱银梅，李海嵘.超声颈动脉内中膜厚度与斑块诊断冠状动脉粥样硬化性心脏病的价值对比J.中国现代医学杂志，2020，30（6）：105-109.王言憬，勇强，刘欣，等.冠状动脉病变程度与颈动脉粥样硬化斑块易损性相关性研究J.中国超声医学杂志，2019，35（7）：601-604.李杰.动态动脉硬化指数联合颈动脉超声与冠状动脉粥样硬化性心脏病的关系J.岭南心血管病杂志，2018，24（1）：34-36，71.Sahadevan M,Chee KH,Tai MS,et al.Prevalence of extracranial carotid atherosclerosis in the patients with coronary artery disease in a tertiary hospital in MalaysiaJ.Medicine,2019,98(15):e15082.Wang C,Yan W,Wang H,et al.APOE polymorphism is associated with blood lipid and serum uric acid metabolism in hypertension or coronary heart disease in a Chinese populationJ.Pharmacogenomics,2019,20(14):1021-1031.李清，杜祥颖.冠状动脉粥样硬化性心脏病与缺血性脑卒中相关性研究进展J.中国动脉硬化杂志，2019，27（10）：82-86.毛琦，项朝君，童武阳，等.冠状动脉粥样硬化患者血清Klotho与糖脂代谢紊乱的相关性研究J.临床心血管病杂志，2020，36（3）：43-48.周迎生，苏申慧，汤雅迪，等.经皮冠状动脉介入治疗术后发生支架内再狭窄的冠心病患者心血管危险因素分析J.中华老年医学杂志，2020，39（4）：386-390.左文杰，杨明明，陈怡帆，等.基于血流储备分数探究冠状动脉功能性缺血的相关因素及其诊断价值J.临床心血管病杂志，2019，35（4）：55-59.（收稿日期：2022-06-10）榄香烯口服乳联合DO化疗方案对食管癌患者血清miR-203、miR-21水平的影响朱红梅，魏 娜，李廷振(南阳张仲景医院肿瘤内科，河南南阳 463000)摘要：目的 探究榄香烯口服乳联合多西紫杉醇+奥沙利铂（DO）化疗方案对食管癌患者血清miR-203、miR-21水平的影响。方法 选取南阳张仲景医院2017年1月2019年2月收治的晚期食管癌患者92例，采用随机数字表法分组，各46例。常规组给予DO化疗方案，研究组在此基础上联合榄香烯口服乳。对比2组客观缓解率（ORR）、疾病控制率（DCR）、免疫功能、血清肿瘤标志物、血清miR-203、miR-21水平及远期生存率变化情况。结果 研究组ORR为60.86%，高于常规组的39.13%（P0.05）；研究组DCR为76.09%，高于常规组的56.52%（P0.05）；治疗后，研究组NK、CD4+高于常规组，CD8+低于常规组（P0.05）；治疗后2组CEA、SCC、TSGF、NSE比较，研究组低于常规组（P0.05）；研究组治疗后miR-203高于常规组，miR-21低于常规组（P0.05）；随访2年显示，研究组1年生存率、2年生存率高于对照组（P0.05）。结论 榄香烯口服乳联合DO化疗方案治疗晚期食管癌可有效调节免疫功能，调控miR-203、miR-21表达，延长生存期限，效果显著。关键词：食管癌；榄香烯口服乳；化疗；免疫功能中图分类号：R735.1 文献标志码：A 文章编号：1004-6879（2023）03-0208-05Effects of Elemene Oral Breast Combined with DO Chemotherapy Regimen on Serum Levels of miR-203 and miR-21 in Patients with Advanced Esophageal CancerZHU Hong-mei,WEI Na,LI Ting-zhen（Department of Medical Oncology,Nanyang Zhang Zhongjing Hospital,Nanyang,Henan,463000,China）1011 12 13 1415 16 1718 Vol.40 No.3 2023承 德 医 学 院 学 报JOURNAL OF CHENGDE MEDICAL UNIVERSITY209食管癌为原发于食管的恶性肿瘤，死亡率高达90%，其早期无特异性症状，多数患者就诊时已进展至中晚期，发生淋巴结转移，失去最佳手术时机1,2。目前，临床治疗食管癌多采取化疗，多西紫杉醇+奥沙利铂（docetaxel+oxaliplatin，DO）方案是其常用方案，其中多西紫杉醇可阻滞肿瘤细胞处于高敏感度G2/M期，进而抑制肿瘤细胞发育、扩散；奥沙利铂通过作用于肿瘤细胞靶点，灭杀肿瘤细胞，且对心脏无毒性，两者联合协同效果明显，可抑制肿瘤细胞增殖，但长期化疗易致使患者免疫系统紊乱，白细胞、血小板水平下降，进而引起机体自发性出血，危及患者生命3,4。榄香烯口服乳为非细胞类抗肿瘤药物，可提升化疗治疗效果，抑制肿瘤细胞DNA表达，起到抗肿瘤作用5。本研究通过探索榄香烯口服乳联合DO化疗方案治疗晚期食管癌的效果，探究其对免疫功能及血清miR-203、miR-21水平的影响，以期为临床治疗提供参考，现报告如下。1 资料与方法1.1 一般资料 选取南阳张仲景医院2019年7月2021年8月收治的晚期食管癌患者92例，采用随机数字表法分为2组，各46例。常规组：男29例，女17例；年龄5167岁，平均年龄（61.242.12）岁；靶病灶直径5.410.4 mm，平均长度（8.120.73）mm。研究组：男26例，女20例；年龄5266岁，平均年龄（60.871.98）岁；靶病灶直径5.510.6 mm，平均长度（7.960.65）mm。2组一般资料比较，无明显差异（P0.05）。1.2 纳入及排除标准 纳入标准：（1）经影像学、病理学检查确诊；（2）自愿参加本次研究，并签署知情同意书。排除标准：（1）气管食管瘘高风险者；（2）对本研究药物禁忌或过敏者。1.3 治疗方法 2组均进行放疗，分别于治疗第1、3、5天予帕洛诺司琼治疗，静脉滴注，剂量0.25 mg，1次/d。常规组第1天采用多西紫杉醇+奥沙利铂治疗，多西紫杉醇静脉滴注75 mg/m2；第2天采用100 mg/m2奥沙利铂溶入500 mL 葡萄糖溶液（5%），静脉滴注。3周为1个化疗周期。研究组在常规组基础上加用榄香烯口服乳治疗，口服，剂量20 mL/次，3次/d。3周为1个化疗疗程，2组共治疗3个化疗疗程。1.4 疗效评估标准 Abstract:Objective To observe the effect of elemene oral breast combined with docetaxel+oxaliplatin(DO)chemotherapy regimen on serum levels of miR-203 and miR-21 in patients with advanced esophageal cancer.Methods A total of 92 patients with advanced esophageal cancer who were treated in Nanyang Zhang Zhongjing Hospital from January 2017 to February 2019 were selected and divided into two groups according to the random number table method,with 46 cases in each group.The routine group was treated with DO,chemotherapy regimen and the study group was treated with elemene oral breast on the basis of the routine group.The objective response rate(ORR),disease control rate(DCR),immune function,serum tumor markers,serum levels of miR-203,miR-21 and changes of long-term survival were compared between the two groups.Results The ORR of the study group was 60.86%,which was higher than that of the routine group(39.13%,P0.05);the DCR of the study group was 76.09%,which was higher than that of the routine group(56.52%,P0.05).After treatment,the levels of NK and CD4+in the study group were higher than those in the routine group,the level of CD8+was lower than that in the routine group(P0.05).After treatment,the CEA,SCC,TSGF,NSE indexes in the study group were lower than those in the routine group(P0.05).After treatment,the level of miR-21 in the study group was higher than that in the routine group,and the level of miR-21 was lower than that in the routine group(P0.05).The two-year follow-up showed that the 1-year survival rate and the 2-year survival rate of the study group were higher than those of the routine group(P0.05).Conclusion Elemene oral breast combined with DO chemotherapy regimen in treatment of advanced esophageal cancer can effectively regulate the immune function of patients and the expression of miR-203 and miR-21,and prolong the survival period with signifi cant effect.Key words:esophageal cancer;elemene oral emulsion;DO chemotherapy regimen;immune function承 德 医 学 院 学 报JOUR