乌苯美司联合放化疗对恶性肿瘤患者免疫功能影响的Meta分析

Effect of Ubenimex Combined with Radiotherapy or Chemotherapy on Immune Functions of Malignant Tumors: A Meta-Analysis

目的系统评价乌苯美司联合放化疗对恶性肿瘤患者的免疫功能影响。方法计算机检索Pub Med、EMBase、Cochrane临床对照试验资料库、中国期刊全文数据库,中文科技期刊全文数据库(维普)和万方数字化期刊全文库,并手工检索相关文献,收集评价乌苯美司联合放化疗对恶性肿瘤患者免疫影响的的中、英文随机对照试验,对符合纳入标准的临床研究进行质量评价和资料提取后,采用Rev Man 5.2统计软件进行Meta分析。结果共纳入9个符合标准的RCT,810例患者。结果显示:与单纯放、化疗相比,联用乌苯美司可显著提高恶性肿瘤患者NK细胞活性、T4/T8比值、白细胞介素-2水平,两组比较差异有统计学意义〔均数差=3.15,95%可信区间(2.35,3.95),P<0.000 01;均数差=0.28,95%可信区间(0.24,0.33),P<0.000 01;均数差=1.38,95%可信区间(0.72,2.05),P<0.0001〕,并显著降低患者可溶性白细胞介素-2受体水平,差异有统计学意义〔均数差=-64.01,95%可信区间(-93.22,-34.80),P<0.0001〕。结论在放、化疗基础上联用乌苯美司可显著改善恶性肿瘤患者的免疫功能,且不良反应较低,受恶性肿瘤患者本身生存状态及时间限制,尚未证实可延长肿瘤患者的生存时长,因此有待更多大样本、高质量研究加以验证。

Objective To evaluate the efficacy and safety of ubenimex combined with radiotherapy or chemotherapy in improving the immune functions of patients with malignant tumors. Methods Pub Med,EMBase,Cochrane Library,CNKI,Wan Fang Data and VIP were searched to collect the English and Chinese literature on randomized controlled trials（ RCTs） on the effect of ubenimex combined with radiotherapy or chemotherapy on the immune functions of patients with malignant tumors. The quality of the papers was assessed according to the Cochrane Handbook and meta-analysis conducted with Rev Man 5. 2 software. Results A total of 9 studies involving 810 patients were included. The results of meta-analysis showed that such a combination therapy effectively improved the activity of NK cells,T4/T8 and IL-2〔MD = 3. 15,95% CI（ 2. 35,3. 95）,P〈 0. 000 01; MD = 0. 28,95% CI（ 0. 24,0. 33）,P〈 0. 000 01; MD = 1. 38,95% CI（ 0. 72,2. 05）,P 〈0. 0001〕while decreasing SIL-2R〔MD =-64. 01,95% CI（-93. 22,-34. 80）,P〈 0. 0001〕. Conclusion Ubenimex combined with radiotherapy or chemotherapy can improve the immune functions of patients with malignant tumors,but more large-scale and high-quality studies are necessary.