[1]郭 娟,张凤玲,薛 娇,等.醋酸甲羟孕酮联合糖蛋白抑制剂对子宫内膜癌化疗患者肿瘤标志物、免疫系统功能和生存质量的影响[J].陕西医学杂志,2023,52(10):1335-1339.[doi:DOI:10.3969/j.issn.1000-7377.2023.10.011]
　GUO Juan,ZHANG Fengling,XUE Jiao,et al.Effects of medroxyprogesterone acetate combined with glycoprotein inhibitors on tumor markers,immune system function and quality of life in patients with endometrial cancer undergoing chemotherapy[J].,2023,52(10):1335-1339.[doi:DOI:10.3969/j.issn.1000-7377.2023.10.011]
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醋酸甲羟孕酮联合糖蛋白抑制剂对子宫内膜癌化疗患者肿瘤标志物、免疫系统功能和生存质量的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年10期
页码:
1335-1339
栏目:
临床研究
出版日期:
2023-10-05

文章信息/Info

Title:
Effects of medroxyprogesterone acetate combined with glycoprotein inhibitors on tumor markers,immune system function and quality of life in patients with endometrial cancer undergoing chemotherapy
作者:
郭 娟; 张凤玲; 薛 娇; 张晨晨; 董 婕
(华中科技大学同济医学院附属同济医院肿瘤科,湖北 武汉 430030)
Author(s):
GUO Juan; ZHANG Fengling; XUE Jiao; ZHANG Chenchen; DONG Jie
(Department of Oncology, Tongji Hospital,Tongji Medical College of HUST,Wuhan 430030,China)
关键词:
醋酸甲羟孕酮;  糖蛋白抑制剂;  子宫内膜癌;  肿瘤标志物;  免疫系统功能;  生存质量
Keywords:
Medroxyprogesterone acetate;  Glycoprotein inhibitor;  Endometrial cancer;  Tumor marker;  Immune system function;  Quality of life
分类号:
R 737.33
DOI:
DOI:10.3969/j.issn.1000-7377.2023.10.011
文献标志码:
A
摘要:
目的:探究醋酸甲羟孕酮联合糖蛋白抑制剂对子宫内膜癌化疗患者肿瘤标志物、免疫系统功能和生存质量的影响。方法:选取94例子宫内膜癌化疗患者作为研究对象,并将其分为观察组和对照组。对照组患者接受常规化疗联合糖蛋白抑制剂(枸橼酸妥瑞米芬片)治疗,观察组在其基础上联合高效孕激素(醋酸甲羟孕酮)治疗。比较两组患者化疗前后肿瘤标志物水平[程序性死亡配体(PD-L1)、糖类抗原 125(CA125)和人附睾上皮分泌蛋白 4(HE4)]、免疫系统功能(CD3+、CD4+/CD8+)和生存质量的变化情况,同时比较两组的肿瘤控制率(DCR)。结果:观察组患者DCR为93.33%(42/45),对照组为77.55%(38/49),观察组较对照组高(P<0.05)。与对照组比较,观察组患者治疗后肿瘤标志物HE4、PD-L1和CA125血清浓度较低(均P<0.05)。在免疫系统功能方面,观察组患者的CD3+和CD4+/CD8+比值高于对照组(均P<0.05)。此外,观察组治疗后卡氏功能状态评分标准(KPS)、欧洲癌症研究与治疗组织的生命质量核心问卷(EORTC QLQ-C30)评分均高于对照组(均P<0.05)。安全性比较,观察组恶心呕吐发生率低于对照组(8.89%与26.53%,P<0.05),两组食欲下降、口腔溃疡、脱发、骨髓抑制以及神经病变发生率比较无统计学差异(均P>0.05)。结论:醋酸甲羟孕酮联合糖蛋白抑制剂在子宫内膜癌化疗中显示出潜在的治疗优势,可显著降低肿瘤标志物水平,改善免疫系统功能,提高患者的生存质量。
Abstract:
Objective:To investigate the effects of medroxyprogesterone acetate combined with glycoprotein inhibitor on tumor markers,immune system function and quality of life in patients with endometrial cancer undergoing chemotherapy.Methods:A total of 94 patients with endometrial cancer undergoing chemotherapy were randomly selected as study objects,and were divided into observation group and control group.The control group was treated with conventional chemotherapy combined with glycoprotein inhibitor(Toureamifen citrate tablet),and the observation group was treated with high-potency progesterone(medroxyprogesterone acetate)on the basis of chemotherapy.The changes of tumor marker levels(PD-L1,CA125 and HE4),immune system function(CD3+,CD4+/CD8+)and quality of life before and after chemotherapy were compared between the two groups,and the tumor control rate(DCR)was compared between the two groups.Results:DCR was 93.33%(42/45)in observation group and 77.55%(38/49)in control group,which was higher in observation group(P<0.05).Compared with the control group,the serum concentrations of tumor markers HE4,PD-L1 and CA125 in the observation group were lower after treatment(all P<0.05).In terms of immune system function,CD3+and CD4+/CD8+ ratios in the observation group were higher than those in the control group(all P<0.05).In addition,the scores of KPS and EORTC QLQ-C30 in the observation group were higher than those in the control group after treatment(all P<0.05).For safety comparison,the incidence of nausea and vomiting in the observation group was lower than that in the control group(8.89% vs.26.53%,P<0.05),and there was no difference in the incidence of appetite loss,oral ulcers,alopecia,bone marrow suppression and neuropathy between the two groups(all P>0.05).Conclusion:Medroxyprogesterone acetate combined with glycoprotein inhibitor shows potential therapeutic advantages in endometrial cancer chemotherapy,which can significantly reduce the level of tumor markers,improve the function of immune system and improve the quality of life of patients.

参考文献/References:

[1] 白治苗,刘玉锋,赵 乐,等.核因子-κB p65和骨桥蛋白在子宫内膜癌组织与细胞中的表达及相关性研究[J].陕西医学杂志,2022,51(3):370-374.
[2] Luna C,Balcacer P,Castillo P,et al.Endometrial cancer from early to advanced-stage disease:An update for radiologists[J].Abdom Radiol(NY),2021,46(11):5325-5336.
[3] 张雅琳,王建梅,王 羽,等.茯苓丸联合醋酸甲地孕酮对绝经后早期子宫内膜癌患者血清hs-CRP、VEGF含量、免疫功能及生存质量的影响[J].临床和实验医学杂志,2022,21(20):2204-2208.
[4] 徐 艺,陈 霞,顾金云,等.醋酸甲羟孕酮片联合复方炔诺酮片治疗围绝经期功能性子宫出血患者的临床研究[J].中国临床药理学杂志,2023,39(6):768-771.
[5] 张双丽,刘 军,何 杰,等.糖蛋白抑制剂联合化疗对子宫内膜癌患者血清[J].中国妇产科临床杂志,2021,22(1):58-59.
[6] 中华人民共和国国家卫生健康委员会.于宫内膜癌诊治规范(2018年版)[J].肿瘤综合治疗电子杂志,2020,6(4):2535-2536.
[7] 中国抗癌协会妇科肿瘤专业委员会.子宫内膜癌诊断与治疗指南(2021年版)[J].中国癌症杂志,2021,31(6):501-512.
[8] 柏 和.基层医生肿瘤诊治手册[M].北京:北京大学医学出版社,2008:356.
[9] Aaronson NK,Ahnmedzai S,Bergman B,et al.The European organization for research and treatment of cancer QLQ-C30:A quality-of-life instrument for use in intermational clinical trials in eoncology[J].J Natl Cancer Inst,1993,85(5):365-376.
[10] 王 熙,吴川清.结直肠癌多药耐药逆转的研究进展[J].国际肿瘤学杂志,2023,50(1):42-46.
[11] Li X,Zhou S,Abrahams CL,et al.Discovery of STRO-002,a novel homogeneous ADC targeting folate receptor alpha,for the treatment of ovarian and endometrial cancers[J].Mol Cancer Ther,2023,22(2):155-167.
[12] 杨培伟,刘光伟,赵文霞.近十年半枝莲抗肿瘤作用机制研究概况[J].环球中医药,2023,16(5):1051-1056.
[13] 蔺 飒,李富慧.P-糖蛋白辅助治疗子宫内膜癌的近远期效果观察[J].实用临床医药杂志,2019,23(11):49-51.
[14] 陈洈伟,徐 丹,王 艳,等.血清HE4、NGAL和CA125联合检测对子宫内膜癌的临床诊断意义[J].陕西医学杂志,2018,47(11):1500-1502.
[15] 马旭兰,夏 迪,王慧霄,等.雌激素通过介导HOTAIR表达对子宫内膜癌细胞增生及裸鼠致瘤能力的影响[J].首都医科大学学报,2019,40(6):894-900.
[16] 余花艳,史中州,仓顺东.糖蛋白抑制剂联合化疗对子宫内膜癌患者PD-L1和CD8+表达及生存质量的影响[J].实用癌症杂志,2022,37(5):786-789.
[17] Harmon QE,Patchel SA,Zhao S,et al.Depot medroxyprogesterone acetate use and the development and progression of uterine leiomyoma[J].Obstet Gynecol,2022,139(5):797-807.
[18] Edfeldt G,Lajoie J,Röhl M,et al.Regular use of depot medroxyprogesterone acetate causes thinning of the superficial lining and apical distribution of human immunodeficiency virus target cells in the human ectocervix[J].J Infect Dis,2022,225(7):1151-1161.
[19] 陈雁南,李飞燕,白忻如,等.高效孕激素联合化疗治疗子宫内膜癌的疗效及对患者血清肿瘤标志物和炎性因子的影响[J].癌症进展,2021,19(8):840-843.
[20] Vanden-Heerik ASVM,Horeweg N,De-Boer SM,et al.Adjuvant therapy for endometrial cancer in the era of molecular classification:Radiotherapy,chemoradiation and novel targets for therapy[J].Int J Gynecol Cancer,2021,31(4):594-604.

备注/Memo

备注/Memo:
基金项目:湖北省卫生健康委员会面上项目(WJ2021M118)
更新日期/Last Update: 2023-10-07