尼妥珠单抗联合顺铂治疗鼻咽癌的临床研究

Clinical trial of nimotuzumab combined with cisplatin in the treatment of patients with nasopharynx cancer

目的观察尼妥珠单抗联合顺铂对鼻咽癌患者的临床疗效,分析其与患者病理组织脑恶性肿瘤缺失基因1(DMBT1)和TESTIN表达的相关性。方法收集本院收治83例鼻咽癌患者的临床资料,均给予尼妥珠单抗200 mg+顺铂40mg·m^(-2),静脉滴注,每周1次,连续治疗6周。用免疫组化法检测治疗前后DMBT1和TESTIN的表达情况及其与患者临床特征及临床疗效的关系。结果免疫组化染色显示,DMBT1阳性共28例(33.73%),TESTIN阳性共26例(31.33%);鼻咽癌患者病理组织DMBT1、TESTIN蛋白阳性表达与其临床分期、分化程度及淋巴结转移情况有显著相关性(P<0.01),而与患者性别、年龄无显著相关性(P>0.05)。患者1年生存率为95.18%,且DMBT1及TESTIN阳性表达患者完全缓解(CR)分别为25.00%,34.62%;总缓解率(RR)分别为71.43%,80.77%。其CR及RR均分别显著高于DMBT1及TESTIN阴性表达者(P<0.01);Spearman相关性分析显示,鼻咽癌患者病理组织DMBT1及TESTIN阳性表达与其临床疗效正相关(P<0.01)。结论尼妥珠单抗联合顺铂对鼻咽癌患者的临床疗效显著,且其与患者病理组织DMBT1及TESTIN蛋白阳性表达具有显著正相关性,两者均可作为鼻咽癌患者临床疗效的评估指标。

Objective To explore the clinical efficacy of nimotuzumab combined with cisplatin in the treatment of nasopharynx cancer patients and the correlation with deleted in malignant brain tumors 1（ DMBT1）,TESTIN expression in pathological tissue. Methods The clinical data of83 nasopharynx cancer patients were selected. The patients were treated with nimotuzumab 200 mg combined with 40 mg·m-2 cisplatin,intravenous injection,1 time per week,and treated for 6 weeks continuously.The expression of pathological tissue DMBT1,TESTIN before treatment and 6 weeks after treatment were detected by immunohistochemical method,and the correlation between DMBT1,TESTIN expression and the clinical symptoms,clinical efficacy was analyzed. Results The immumohistochemical staining showed that,the patients with DMBT1 positive expression were 28 cases（ 33. 73%）,the patients with TESTIN positive expression were 26 cases（ 31. 33%）. There was significant correlation between the expression of pathological tissue DMBT1,TESTIN protein and the clinical stages,differentiated degree and lymph node metastasis（ P〈0. 01）,while there was no significant correlation with gender andage（ P〈0. 05）. The 1 year survival rate was 95. 18%,and the complete response（ CR） of patients with DMBT1,TESTIN positive expression were 25. 00%,34. 62%; the response rate（ RR） were 71. 43%,80. 77%,higher than those of patients with DMBT1,TESTIN negative expression（ P〈0. 01）. The Spearman correlation analysis showed that,the pathological tissue DMBT1 and TESTIN positive expression of nasopharynx cancer patients had a positive correlation with the clinical efficacy（ P〈0. 01）. Conclusion The clinical efficacy of nimotuzumab combined with cisplatin for nasopharynx cancer patients is remarkable,and which has a positive correlation with pathological tissue DMBT1,TESTIN protein positive expression,and they can act as the evaluation indexes of the clinical efficacy of nasopharynx cancer patients.