恶性胸腔积液接受内皮抑素联合甘露聚糖肽胸腔灌注治疗对胸水中恶性分子表达的影响

Effect of intrapleural endostatin and mannatide infusion on malignant molecule expression in pleural fluid of malignant pleural effusion

目的:研究恶性胸腔积液接受内皮抑素联合甘露聚糖肽胸腔灌注治疗对胸水中恶性分子表达的影响。方法:选择2013年4月~2015年12月期间在河省南阳市第二人民医院接受治疗的肺癌合并恶性胸腔积液患者,随机分为两组,观察组接受内皮抑素联合甘露聚糖肽胸腔灌注治疗,对照组接受常规胸腔灌注治疗。治疗后4周时,采集胸水标本并测定肿瘤标志物、侵袭相关分子、VEGF相关分子、抗肿瘤细胞因子的含量。结果:治疗后4周时,观察组患者胸水中CEA、CYFRA21-1、NSE、SCC-Ag、CXCL12、CXCR4、MMP2、MMP9、VEGF-A、VEGF-B、VEGF-C、VEGF-D、VEGF-R1、VEGF-R2、VEGF-R的含量均显著低于对照组,LASS2/TMSG-1、IFN-γ、IL-2、TNF-α、IL-17、IL-23的含量显著高于对照组。结论:内皮抑素联合甘露聚糖肽胸腔灌注治疗恶性胸腔积液能够更为有效地杀伤癌细胞,抑制细胞侵袭、血管及淋巴管新生,增强抗肿瘤免疫应答。

Objective：To study the effect of intrapleural endostatin and mannatide infusion on malignant molecule expression in pleural fluid of malignant pleural effusion.Methods：Patients with lung cancer and malignant pleural effusion treated in our hospital between April 2013 and December 2015 were selected and randomly divided into two groups,the observation group that received intrapleural endostatin and mannatide infusion treatment and control group that accepted routine intrapleural infusion treatment.Four weeks after treatment,the pleural fluid samples were collected to determine the levels of tumor markers,invasion-related molecules,VEGF-related molecules and anti-tumor cytokines.Results：Four weeks after treatment,CEA,CYFRA21-1,NSE,SCC-Ag,CXCL12,CXCR4,MMP2,MMP9,VEGF-A,VEGF-B,VEGF-C,VEGF-D,VEGFR1,VEGF-R2 and VEGF-R3 levels in pleural fluid of observation group were significantly lower than those of control group while LASS2/TMSG-1,IFN-γ,IL-2,TNF-α,IL-17 and IL-23 levels were significantly higher than those of control group.Conclusions：Intrapleural endostatin and mannatide infusion treatment of malignant pleural effusion can more effectively kill cancer cells,inhibit cell invasion,angiogenesis and lymphangiogenesis,and enhance antitumor immune response.