香菇多糖协同增强GP方案治疗Ⅳ期肺鳞癌的疗效观察

Efficacy of synergistic combination of lentinan and GP regimen in stage Ⅳlung squamous cell carcinoma

目的：研究香菇多糖协同增强吉西他滨联合顺铂（GP方案）治疗Ⅳ期肺鳞癌疗效及其机制。方法根据治疗方法将Ⅳ期肺鳞癌患者60例分为单纯GP方案治疗组（CON组）和香菇多糖联用GP方案治疗组（LGP组），各组30例患者，比较两组患者疗效，不良反应发生率，CD3＋、CD4＋、CD8＋T淋巴细胞亚群，生活质量的差异。结果 LGP组患者治疗有效率为86.7%高于CON患者治疗有效率为76.7%，但差异无统计学意义（P﹥0.05）；LGP组患者Ⅲ～Ⅳ级和I～Ⅳ级胃肠道反应、骨髓抑制和肾功能损害不良反应发生率均低于CON组患者（P﹤0.05）；CON组患者化疗后的CD3＋、CD4＋、CD8＋和CD4＋/CD8＋与化疗前无明显差异（P﹥0.05），LGP组患者化疗后的CD3＋、CD4＋和CD8＋均高于化疗前（P﹤0.05），且高于CON组患者（P﹤0.05）；两组患者化疗后生存质量均优于化疗前；LGP组患者化疗后生存质量优于CON组患者，化疗后生理状况、社会/家庭状况、情感状况、功能状况和附加关注的差异均具有统计学意义（P﹤0.05）。结论香菇多糖可协同增强GP方案治疗Ⅳ期肺鳞癌的疗效，提高患者生存质量，其机制可能与香菇多糖显著提高T淋巴细胞免疫有关。

Objective To investigate the efficacy of the synergistic combination of lentinan and GP regimen in stage IV lung squamous cell carcinoma （SCC） and the underlying mechanism. Method Patients with stage IV lung SCC were stratified as CON group and LGP group as per the respective treatment, with GP regimen alone or lentinan＋GP regimen, respectively, with 30 cases in each, the efficacy, adverse reactions, CD3＋, CD4＋and CD8＋T lymphocyte subsets and quality of life （QoL） were summarized and compared. Result The response rate （RR） in LGP group was 86.7%, and was higher than that in CON group at 76.7%, while there was no statistically significant difference （P〉0.05）. The CD3＋, CD4＋and CD8＋T lymphocyte subsets and QoL remained stable after chemotherapy in CON group （P〈0.05）, but were significantly improved in LGP group after chemotherapy （P〈0.05）, and were also better than that in CON group （P〈0.05）;The QoL was improved in both groups after chemotherapy, and LGP group had superior QoL than CON group af-ter treatment, besides, significant differences were also observed in respect of physical function, social/family status, emo-tional status, functional status and other additional measures of interest （P〈0.05）. Conclusion Lentinan significantly pro-motes the efficacy of GP regimen in stage IV lung squamous cell carcinoma, and helps improve quality of life, which is potentially attributable to the enhancement of T lymphocyte immunity.