黄芪联合辅助化疗对NSCLC癌灶VEGF表达、MVD及免疫功能的影响

Effect of Astragalus and chemotherapy on the expression of VEGF in NSCLC,MVD and immune function

目的探讨黄芪联合紫杉醇、顺铂化疗方案对非小细胞肺癌（NSCLC）患者癌灶组织血管内皮生长因子（VEGF）表达、微血管密度（MVD）及免疫功能的影响。方法随机数字表法将92例NSCLC患者分成研究组和对照组,各46例。均予以新辅助化疗＋手术治疗方案;研究组在化疗当日联合黄芪多糖静脉滴注。比较2组治疗前后癌灶组织VEGF表达情况、MVD值及免疫功能指标检测结果差异,记录其近、远期疗效及毒副反应发生情况。结果治疗后,2组患者癌灶组织VEGF阳性率、MVD值及血CD8~＋检测结果均较治疗前明显降低（P〈0.05）,且研究组〈对照组（P〈0.05）;血CD3~＋、CD4~＋及自然杀伤细胞（NK细胞）比值检测结果则较治疗前明显提高（P〈0.05）,且研究组〉对照组（P〈0.05）。2组近期疗效、5年生存率比较均无统计学意义;研究组中重度骨髓抑制及肝、肾毒副反应发生率均明显低于对照组（P〈0.05）。结论辅助化疗联合黄芪多糖静脉滴注方案对NSCLC患者MVD水平、癌灶VEGF表达情况及免疫功能状态均有一定改善作用。

Objective To investigate the effect of Astragalus and chemotherapy on the expression of vascular endothelial growth factor（VEGF） in non-small cell lung cancer（ NSCLC）, microvessel density（MVD） and immune function. Methods 92 patients with NSCLC were divided into the study group and the control group, 46 cases in each group. Both groups were treated with neoadjuvant chemotherapy and operation, and the study group was treated with astragalus polysaccharide. The expression of VEGF in cancer tissues, MVD and immune function were compared between the two groups. The short-term and long-term curative effect and the incidence of adverse reactions were recorded. Results After treatment, positive rates of VEGF, MVD and blood CD8 ＋ were significantly decreased in two groups （P 〈 0.05 ）, showing study group 〈 control group （P 〈 0.05 ）, while blood CD3 ＋ , CD4 ＋ and ratio of NK ceils were significantly increased （ P 〈 0. 05 ）, showing study 〉 control group （ P 〈 0. 05 ）. There were no significant differences between the two groups in short-term curative effect and 5 year survival rates. The incidence rates of side effects in the study group were significantly lower than those in the control group （ P 〈 0. 05 ）. Conclusion Adjuvant chemotherapy combined with intravenous infusion of Astragalus Polysaccharide can improve MVD, the expression of VEGF and immune function in patients with NSCLC.