大分割放疗联合多西他赛对高海拔地区非小细胞肺癌患者血清MMP-9、TGF-β1和VEGF表达的影响

目的观察大分割放疗联合多西他赛对高海拔地区非小细胞肺癌患者血清基质金属蛋白酶9(MMP-9)、转化生长因子-β1(TGF-β1)和血管内皮生长因子(VEGF)表达的影响。方法选择2015年8月-2017年8月青海省第五人民医院放疗一科收治的高海拔地区非小细胞肺癌患者130例作为研究对象,按随机数字法表分为2组,各65例。对照组患者给予常规X射线照射联合多西他赛治疗,试验组患者给予大分割放疗联合多西他赛治疗,治疗后比较2组患者治疗前后血清MMP-9、TGF-β1、VEGF、T细胞亚群水平及骨髓抑制情况,观察不良反应及临床疗效,随访2年患者预后生存情况。结果与治疗前比较,2组患者血清MMP-9、TGF-β1、VEGF及CD8^+水平明显降低,血清CD3^+、CD4^+、CD4^+/CD8^+均明显升高,且试验组患者上述指标改善较对照组更为显著(t/P=4.424/0.000,11.259/0.000,8.873/0.0002.279/0.012,2.123/0.018,3.330/0.001,3.313/0.001)。与治疗前比较,治疗后2组患者的白细胞、血红蛋白及血小板水平均明显降低,而试验组降低程度低于对照组(t/P=14.734/0.000,4.342/0.000,5.787/0.000)。试验组患者疗效缓解率高于对照组,不良反应发生率低于对照组(χ^2/P=17.069/0.000,5.125/0.024)。结论大分割放疗联合多西他赛治疗高海拔地区非小细胞肺癌患者,可以明显降低血清MMP-9、TGF-β1和VEGF水平,增强机体免疫力,减少不良反应发生,改善预后生存情况,效果显著。

Effects of large fraction radiotherapy combined with docetaxel on the expression of serum MMP-9,TGF-β1 and VEGF in patients with non-small cell lung cancer at high altitude

Objective To observe the effects of segmented radiotherapy combined with docetaxel on the expressions of serum MMP-9,TGF-β1 and VEGF in patients with non-small cell lung cancer at high altitude,and provide a reference for their clinical diagnosis and treatment.Methods From August 2015 to August 2017,130 patients with non-small cell lung cancer in the high altitude area treated by the First Department of Radiation Therapy of the Fifth People’s Hospital of Qinghai Province were selected as the research objects.They were divided into 2 groups according to the random number table,with 65 cases in each.Patients in the control group were treated with conventional X-ray irradiation combined with docetaxel.Patients in the test group were treated with segmented radiotherapy combined with docetaxel,both of which were treated for 4 cycles.Changes in serum matrix metalloproteinase 9(MMP-9),transforming growth factor 1(TGF-1),vascular endothelial growth factor(VEGF),T cell subsets,and myelo suppression,adverse reactions,and clinical efficacy of the 2 groups of patients before and after treatment were compared.Results Compared with before treatment,the levels of MMP-9,TGF-β1,VEGF and CD8 in serum were significantly lower,the levels of CD3^+,CD4^+,CD4^+/CD8^+in serum of the two groups were significantly higher,and the improvement of the above indexes in the experimental group was more significant(t/P=4.424/0.000,t/P=11.259/0.000,t/P=8.873/0.000,t/P=2.279/0.012,t/P=2.123/0.018,t/P=3.330/0.001,t/P=3.313/0.001).The remission rate was higher than that in the control group and the incidence of myelosuppression and adverse reactions in the experimental group was lower than that in the control group(χ^2/P=5.125/0.024,χ^2/P=17.069/0.000).Conclusion Grand segmentation radiotherapy combined with docetaxel in the treatment of non-small cell lung cancer patients at high altitude can significantly reduce the serum levels of MMP-9,TGF-β1 and VEGF,enhance the body immunity,reduce the occurrence of adverse reactions,improve the prognosis and survival,with significant effect,which has certain clinical application value.