手术联合化疗对小儿神经母细胞瘤患者MMP-2、TIMP-1、VEGF、NSE、LDH及细胞免疫功能的影响

Effects of operation combined with chemotherapy on MMP-2,TIMP-1,VEGF,NSE,LDH and immunologic function in children with neuroblastoma

目的:探讨手术联合化疗对小儿神经母细胞瘤(NB)患者基质金属蛋白酶-2(MMP-2)、金属蛋白酶-1组织抑制因子(TIMP-1)、血管内皮生长因子(VEGF)、神经元特异性烯醇化酶(NSE)、乳酸脱氢酶(LDH)及细胞免疫功能的影响。方法:选择2014年1月~2017年1月我院收治的90例NB患儿,随机分为对照组和实验组,各45例。对照组患儿单纯给予化疗7个疗程,实验组患儿给予化疗7个疗程后再联合手术治疗。比较两组患儿治疗前后血清MMP-2、TIMP-1、VEGF、NSE、LDH、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白E(IgE)水平以及外周血总T淋巴细胞(TTL)、T辅助淋巴细胞(THL)、T抑制淋巴细胞(TSL)、自然杀伤细胞(NK)、CD4^+/CD8^+。结果:两组治疗前的血清MMP-2、TIMP-1、VEGF、NSE、LDH水平比较,差异无统计学意义(P>0.05);两组治疗后的血清MMP-2、TIMP-1、VEGF、NSE、LDH水平相比治疗前均较低,且实验组治疗后血清MMP-2、TIMP-1、VEGF、NSE、LDH水平变化均优于对照组,差异均具有统计学意义(P<0.05)。两组治疗前的血清IgG、IgA、IgM、IgE水平比较,差异无统计学意义(P>0.05);两组治疗后的血清IgG、IgA、IgM、IgE水平相比治疗前均较低,且实验组治疗后血清IgG、IgA、IgM、IgE水平变化均优于对照组,差异均具有统计学意义(P<0.05)。两组治疗前的外周血TTL、THL、TSL、NK、CD4^+/CD8^+比较,差异无统计学意义(P>0.05);两组治疗后的TTL、CD4^+/CD8^+相比治疗前均较低、THL、TSL、NK相比治疗前均较高,且实验组治疗后外周血TTL、THL、TSL、NK、CD4^+/CD8^+变化均优于对照组,差异均具有统计学意义(P<0.05)。结论:手术联合化疗能够抑制小儿NB的浸润转移,提升细胞免疫功能,值得在临床上推广应用。

Objective:To study the effects of operation combined with chemotherapy on MMP-2,TIMP-1,VEGF,NSE,LDH and immunologic function in children with neuroblastoma(NB).Methods:A total of 90 children with NB in our hospital from January 2014 to January 2017 were enrolled in this study.The subjects were divided into the control group(n=45)and the treatment group(n=45)randomly.The control group were treated with operation for 7 periods,the treatment group were treated with operation combined with chemotherapy for 7 periods.The serum MMP-2,TIMP-1,VEGF,NSE,LDH,IgG,IgA,IgM,IgE and peripheral blood TTL,THL,TSL,NK,CD4^+/CD8^+of the two groups before and after treatment were compared.Results:There were no significantly differences of the serum MMP-2,TIMP-1,VEGF,NSE,LDH of the two groups before treatment(P>0.05).The serum MMP-2,TIMP-1,VEGF,NSE,LDH of the two groups after treatment were significantly lower than before treatment(P<0.05),and that of the treatment group after treatment were significantly lower than the control group(P<0.05).There were no significantly differences of the serum IgG,IgA,IgM,IgE of the two groups before treatment(P>0.05).The serum IgG,IgA,IgM,IgE of the two groups after treatment were significantly lower than before treatment(P<0.05),and that of the treatment group after treatment were significantly lower than the control group(P<0.05).There were no significantly differences of the peripheral blood TTL,THL,TSL,NK,CD4^+/CD8^+of the two groups before treatment(P>0.05).The peripheral blood TTL,CD4^+/CD8^+of the two groups after treatment were significantly lower than before treatment(P<0.05),the peripheral blood THL,TSL,NK of the two groups after treatment were significantly higher than before treatment(P<0.05),and that of the treatment group after treatment were significantly better than the control group(P<0.05).Conclusions:Operation combined with chemotherapy can inhabit the tumor infiltration and metastasis of the children with NB,can improve the cellular immunity function,and it was worthy clinical application.