多西紫杉醇联合奥沙利铂新辅助化疗对子宫颈癌的临床疗效观察

The Clinical Efficacy of Docetaxel and Oxaliplatin Neoadjuvant Chemotherapy for Patients with Cervical Cancer

目的研究多西紫杉醇、奥沙利铂新辅助化疗(NAC)对子宫颈癌(CC)患者的临床疗效以及对叶酸、线粒体融合蛋白2、p16蛋白的影响。方法选取2014年7月-2016年6月我院收治的156例CC患者,采用随机数表法均分为观察组与对照组。观察组给予奥沙利铂联合多西紫杉醇新辅助化疗,对照组给予顺铂联合多西紫杉醇化疗。观察两组患者化疗前后CD3^+、CD4^+、CD8^+、CD4^+/CD8^+及NK细胞水平,血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、γ-干扰素(IFN-γ)水平,叶酸、MFN2、p16蛋白表达水平,化疗后临床疗效及化疗期间药物毒副反应发生情况。结果化疗后,观察组CD3^+、CD4^+、CD4^+/CD8^+、NK细胞、IL-2、IFN-γ、叶酸水平均显著高于对照组,CD8^+、IL-6、MFN2、p16蛋白水平显著低于对照组(P<0.05)。观察组59例(75.64%)分期降低,降期率显著高于对照组(61.54%)(P<0.05),缓解率(74.36%)明显高于对照组(48.72%)(P<0.05),总有效率(88.46%)亦显著高于对照组(73.08%)(P<0.05)。化疗期间,观察组毒副反应发生率均低于对照组,但差异无统计学意义(P>0.05)。结论与顺铂联合多西紫杉醇相比,奥沙利铂联合多西紫杉醇新辅助化疗用于子宫颈癌的临床疗效更好,可有效解除机体免疫抑制,提高叶酸水平,下调MFN2、p16蛋白的表达。

Objective To investigate the clinical efficacy of docetaxel and oxaliplatin neoadjuvant chemotherapy(NAC)for patients with cervical cancer(CC),as well as its effects on serum folic acid and expressions of mitochondrial fusion protein 2(MFN2)and p16 proteins of patients.Methods A total of 156 cases of CC patients admitted to our hospital between July 2014 and June 2016 were enrolled into this study.The patients were divided into observation group(n=78)and control group(n=78)using the random number table method.Patients in observation group were treated with the neoadjuvant chemotherapy regimen of oxaliplatin and docetaxel,and those in control group had the chemotherapy regimen of cisplatinum and docetaxel.Detect the ratio of CD3^+,CD4^+,CD8^+and NK cells,and the levels of serum interleukin-2(IL-2),interleukin-6(IL-6)and interferon-gamma(IFN-γ)and indexes such as folic acid,MFN2 and p16 protein before and after chemotherapy.The clinical efficacy after chemotherapy and adverse effects during chemotherapy were also observed in the two groups Results After chemotherapy,the levels of CD3^+,CD4^+,NK cells,IL-2,IFN-γand folic acid,and the CD4^+/CD8^+in observation group were higher than in control group,while the levels of CD8^+,IL-6,MFN2 and p16 protein in observation group were lower than in control group(P<0.05).Fifty-nine cases(75.64%)in observation group had their stages decreased,and the decrease rate was significantly higher than that of control group(61.54%)(P<0.05).The remission rate of the observation group(74.36%)was also significantly higher than that of control group(48.72%)(P<0.05).And the total effective rate of observation group(88.46%)was higher than that of control group(73.08%)(P<0.05).During the chemotherapy,the incidence of various toxic reactions in observation group was lower than that of control group,but the difference was not statistically significant between the two groups(P>0.05).Conclusion The chemotherapy of oxaliplatin plus docetaxel is more effective than the regimen of cisplatinum and docetaxel for cervical cancer patients.It could effectively relieve immune suppression increase folic acid level and reduce the levels of MFN2 and p16 protein.