奥沙利铂联合放疗治疗鼻咽癌患者的效果及对血清Bcl-2、Bax蛋白水平的影响

Effect of oxaliplatin combined with radiotherapy on serum Bcl-2, Bax protein level in patients with nasopharyngeal carcinoma

目的探究奥沙利铂联合放疗治疗鼻咽癌患者的效果及对血清B淋巴细胞瘤-2基因(Bcl-2)、Bax蛋白水平的影响。方法选取2016年1月至2017年12月于息县人民医院进行治疗的鼻咽癌患者160例作为研究对象,按照随机数表法分为放疗组和联合组,各80例。对放疗组患者进行放射治疗,联合组在放射治疗的基础上使用奥沙利铂进行联合治疗。应用化学发光分析法检测血清癌胚抗原(CEA)、糖链抗原125(CA125)水平,酶联免疫吸附法检测血管内皮生长因子(VEGF)水平,Western blot法检测Bcl-2、Bax蛋白水平,对两组患者T淋巴细胞亚群CD3^+、CD4^+、CD8^+进行测定。比较两组患者生活质量、治疗效果及不良反应。结果治疗后两组患者血清CEA、CA125、VEGF水平均低于治疗前,且联合组低于放疗组,差异有统计学意义(均P<0.05)。治疗后两组患者各项生活质量评分均高于治疗前,且联合组高于放疗组,差异有统计学意义(均P<0.05)。治疗后两组患者CD3^+、CD4^+水平均高于治疗前,CD8^+水平低于治疗前,且联合组患者CD3^+、CD4^+水平高于放疗组,CD8^+水平低于放疗组,差异有统计学意义(均P<0.05)。联合组患者治疗总有效率高于放疗组,差异有统计学意义(P<0.05)。两组患者治疗后Bcl-2水平均低于治疗前,Bax水平高于治疗前,且联合组患者Bcl-2水平低于放疗组,Bax水平高于放疗组,差异有统计学意义(均P<0.05)。联合组患者治疗过程中不良反应发生率低于放疗组,差异有统计学意义(P<0.05)。结论使用奥沙利铂联合放疗对鼻咽癌患者进行治疗,能够显著调控血清肿瘤标志物水平,提高患者生活质量。

Objective To investigate the effect of oxaliplatin in the treatment of nasopharyngeal carcinoma and its effect on the levels of B-cell lymphoma-2(Bcl-2) and Bax in serum. Methods One hundred and sixty patients with nasopharyngeal carcinoma (NPC) treated in People's Hospital of Xixian from January 2016 to December 2017 were randomly divided into radiotherapy group ( n = 80) and combined group ( n = 80). The patients in the radiotherapy group were treated with radiotherapy, while the patients in the combined group were treated with oxaliplatin on the basis of radiotherapy. The levels of serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA125) were detected by chemiluminescence analysis, and the level of vascular endothelial growth factor (VEGF) was detected by enzyme-linked immunosorbent assay. The levels of Bcl-2, Bax protein was detected by Western blot. CD3^+, CD4^+ and CD8^+ of T-cell lymphocyte subsets were measured. The quality of life, therapeutic effect and adverse reactions were compared between the two groups. Results After treatment, the levels of serum CEA, CA125, VEGF in the two groups were lower than those before treatment, and the levels in the combined group were lower than that in the radiotherapy group, the differences were statistically significant (all P < 0.05). After treatment, the scores of quality of life in the two groups were higher than those before treatment, and the scores in the combined group were higher than that in the radiotherapy group (all P < 0.05). After treatment, CD3^+ and CD4^+ levels were higher in both groups than those before treatment, CD8^+ level was lower than that before treatment, CD3^+ and CD4^+ levels in combined group were higher than that in radiotherapy group, and CD8^+ level was lower than that in radiotherapy group, the differences were statistically significant (all P < 0.05). The total effective rate of the combined group was higher than that of the radiotherapy group ( P < 0.05). After treatment, the levels of Bcl-2 in the two groups were lower than those before treatment, the level of Bax was higher than that before treatment, and the level of Bcl-2 in the combined group was lower than that in the radiotherapy group, and the level of Bax in the combined group was significantly higher than that in the radiotherapy group (all P < 0.05). The incidence of adverse reactions in the combined group was significantly lower than that in the radiotherapy group ( P < 0.05). Conclusion Oxaliplatin combined with radiotherapy can significantly regulate the level of serum tumor markers and improve the quality of life of patients with nasopharyngeal carcinoma.