亚砷酸对中晚期原发性肝癌放疗患者血清中IGF-Ⅱ和IGFBP-2水平影响的研究

The effect of injectio arsenous acid on the serum levels of IGF-Ⅱ and IGFBP-2 in patients with middle or advanced primary liver cancer

目的:观察亚砷酸对中晚期原发性肝癌患者放疗前后血清中IGF-Ⅱ和IGFBP-2水平变化的影响,探讨其相互关系及临床意义。方法:我院92例中晚期肝癌患者随机分为对照组和治疗组,各46例。两组均采用三维适形放疗,2Gy/次,1次/d,5次/周,总剂量为55-60Gy。治疗组在放疗同时加用0.1%亚砷酸注射液10mg+500ml生理盐水,1次/d,连用14d为1周期,至少治疗2周期。观察两组近期疗效、生活质量的改善。ELISA法检测放疗前后血清中IGF-Ⅱ、IGFBP-2的水平变化。同时取健康人群46例为正常对照组。结果:IGF-Ⅱ、IGFBP-2的检测:对照组和治疗组放疗前IGF-Ⅱ、IGFBP-2水平明显高于正常对照组,差异均有统计学意义(P<0.05)。对照组与治疗组放疗前IGF-Ⅱ、IGFBP-2水平比较,差异无统计学意义(P>0.05)。治疗组放疗后IGF-Ⅱ、IGFBP-2水平明显低于对照组,差异均有统计学意义(P<0.05)。近期疗效:治疗组CR+PR 20例,有效率为43.48%,对照组CR+PR 11例,有效率为23.91%,两者比较差异有统计学意义(P<0.05)。生活质量的改善:治疗组治疗后生活质量改善患者19例,稳定16例,下降11例。对照组改善患者11例,稳定15例,下降20例,两组间比较有显著差异(P<0.05)。结论:中晚期肝癌患者血清IGF-II、IGFBP-2水平升高。亚砷酸可以降低中晚期肝癌患者血清IGF-II、IGFBP-2水平,并提高近期疗效,提高生活质量。

Objective：To study the effect of injectio arsenous acid on serum IGF - Ⅱ and IGFBP - 2 level of pa- tients with middle or advanced primary liver cancer. Methods： Ninety - two patients with middle or advanced primary liver cancer were randomly divided into the treatment group and control group with forty - six cases in each group. An- other forty - six cases of healthy people were selected as normal control group. All ninety - two cancer cases were giv- en three- dimensional conformal radiotherapy at a total dose of 55 -60Gy, 2Gy/f, 5 fractions/week. Forty -six pa- tients in the treatment group were used with arsenious acid injection alone while in radiotherapy. 0.1% arsenious acid injection at single dose of lOmg/d and O. 9% saline 500ml/d were used for fourteen days as one cycle. After two or more cycles, serum IGF - II and IGFBP - 2 level, the whole response rates （ complete response rate and partial re- sponse rate） and life quality were observed. Serum IGF - Ⅱ , IGFBP -2 levels were detected by ELISA. Results：Be- fore radiotherapy, serum IGF - 1I, IGFBP - 2 levels of the treatment group and control group where was no statistically significant difference between them （ P 〉 0.05 ） significantly higher than the control group （P 〈 0. 05）. After radiother- apy, serum IGF - Ⅱ , IGFBP- 2 levels of treatment group were significantly lower than the control group （P 〈 0.05 ）. The whole response rate in treatment group was 43.48% ,compared to 23.91% in control group（P 〈0.05）. The life quality of nineteen cases were improved in treatment group, sixteen cases stable, eleven cases decreased, compared to eleven improved, fifteen cases stable, twenty cases decreased in control group. Obviously, life quality of treatment group was significant higer than control group. Conclusion：The injectio arsenous acid could significantly reduce the serum IGF - Ⅱ, IGFBP - 2 level of patients with middle or advanced primary liver cancer in radiotherapy and impro- ving their response rate and life quality.