溶瘤病毒药物H101提高鼻咽癌淋巴结转移化疗疗效及其可能机制

Oncolytic virus H101 increases the effectiveness of chemotherapy on lymph node metastasis of nasopharyngeal carcinoma and its possible mechanism

目的:观察溶瘤病毒药物H101联合化疗药物对鼻咽癌淋巴结转移的治疗效果,初步探讨H101的作用机制。方法:在广西医科大学附属肿瘤医院住院经鼻咽部活检确诊为鼻咽癌并有淋巴结转移的患者62例,随机分成2组:试验组30例,其中Ⅱ期7例、Ⅲ期15例、Ⅳa期8例,采用H101转移淋巴结内注射结合以顺铂为主的化疗进行治疗;对照组32例,其中Ⅱ期8例、Ⅲ期15例、Ⅳa期9例,仅进行以顺铂为主的化疗。应用免疫组化法检测鼻咽部癌组织P16、nm23蛋白表达,并分析其与H101治疗疗效的相关性。结果:试验组H101局部注射结合化疗治疗颈部转移淋巴结总有效率为83.3%,对照组总有效率为43.8%,两组总有效率差异有统计学意义(P<0.01)。试验组30例鼻咽癌组织中P16、nm23蛋白表达阳性率分别为30.0%、83.3%;P16蛋白表达阳性患者的治疗有效率为95.2%,阴性患者有效率为55.6%,其差异有统计学意义(P<0.01);nm23蛋白表达阳性患者的治疗有效率为84.0%,nm23阴性患者的有效率为80.0%,其差异无统计学意义。结论:溶瘤病毒药H101结合化疗可提高鼻咽癌淋巴结转移的疗效,P16表达异常可能是H101作用机制的一个重要方面。

Objective： To observe the effectiveness of oncolytic virus H101 combined with chemotherapy in treatment of patients with lymph node metastasis of nasopharyngeal carcinoma, and to discuss the related mechanism. Methods： Sixty-two biopsy-confirmed specimens of nasopharyngeal carcinoma from patients who received nasopharyngeal endoscopy in the Tumor Hospital Affiliated to Guangxi Medical University were randomly divided into 2 groups： experimental group （n = 30, including Ⅱ[7], Ⅲ[15], and Ⅳ a [8] ; combined chemotherapy with H101 and cisplatin） and the control group （ n = 32, including Ⅱ[8], Ⅲ[15], and Ⅳa [9] ; chemotherapy with cisplatin alone） . Immunohistochemical method was used to detect the expression of P16 and nm23 protein and its relationship with the effectiveness of H101 was analysed. Results： The overall effective rate for cervical lymph node metastasis was 83.3% in the experiment group and 43.8% in the control group （P 〈 0.01 ）. Expression rates of P16 and nm23 protein in the experiment group were 30.0% and 83.3%, respectively. The effective rate was 95.2% in patient positive of P16 protein and 55.6% in those negative of P16 protein（P 〈0.01 ） ; and the numbers for nm23 protein were 84.0% and 80.0%, with no significant difference. Conclusion： Oncolytic virus H101 combined with chemotherapy can improve the prognosis of lymph node metastasis of nasopharyngeal carcinoma, and the disordered p16 expression might be related to the mechanism of H101 action.