沙利度胺联合CHOP方案对弥漫大B细胞淋巴瘤患者的免疫功能、血管内皮生长因子及炎症因子的影响

The effect of thalidomide combined with CHOP on immune function, angiogenesis and inflammatory factors in patients with Diffuse Large B-Cell Lymphoma

目的:探究沙利度胺联合CHOP方案化疗对弥漫大B细胞淋巴瘤(DLBCL)患者的免疫球蛋白、血管内皮生长因子、乳酸脱氢酶及炎症因子等的影响。方法:收集本院血液肿瘤科住院的83例弥漫性大B细胞淋巴瘤患者。化疗组40例,给予CHOP化疗方案治疗。沙利度胺组43例,给予沙利度胺联合CHOP化疗方案治疗。检测治疗前后两组免疫球蛋白IgG、IgA、IgM,血管内皮生长因子(VEGF)、肿瘤坏死因子(TNF-α),乳酸盐脱氢酶(LDH)、β2微球蛋白(β2-MG)及Th17细胞比率及自然杀伤细胞(NK)比率。结果:两组治疗前免疫球蛋白、炎症因子及其他相关因子等比较,差异无统计学意义(P>0.05)。经过6个周期治疗后,化疗组免疫球蛋白IgG、IgA、IgM、VEGF、LDH、β2-MG水平及NK细胞比率均显著低于治疗前(P<0.05),TNF-α、Th17细胞比率显著高于治疗前;沙利度胺组IgG、IgA、IgM、VEGF、LDH、β2-MG水平均显著低于治疗前(P<0.05),TNF-α、Th17细胞比率及NK细胞比率均显著高于治疗前(P<0.05);且沙利度胺组IgG、IgA、IgM、VEGF、LDH、β2-MG水平均显著低于化疗组(P<0.05),TNF-α、Th17细胞比率及NK细胞比率均显著高于化疗组(P<0.05)。结论:沙利度胺联合CHOP方案对弥漫大B细胞淋巴瘤的治疗效果显著,可明显降低患者体内的血管内皮生长因子、乳酸脱氢酶、β2微球蛋白水平,改善患者的免疫功能,提高机体的肿瘤坏死因子水平、Th17细胞及自然杀伤细胞比率,为临床弥漫大B细胞淋巴瘤的治疗提供参考依据。

Objective:ObjectiveThis study mainly explored the effect of thalidomide combined with CHOPchemotherapy regimen on immunoglobulin,VEGF,lactate dehydrogenase,inflammatory factors and other related factors in patients with diffuse large B-cell lymphoma(DLBCL).Methods:A total of 83 patients with DLBCLadmitted to Department of Hematology and Oncologyin our hospital from December 2012 to December 2018 were collected.CHOP chemotherapy was given to 40 patients in the chemotherapy group.43 patients in the thalidomide group were treated with thalidomide combined with CHOP chemotherapy.Immunoglobulin IgG,IgA,IgM,vascular endothelial growth factor(VEGF),tumor necrosis factor(TNF-α),lactate dehydrogenase(LDH),β2 microglobulin(β2-MG),Th17 cell ratio and natural killer cell(NK)ratio were measured before and after treatment.Results:There were no significant differences in immunoglobulin,inflammatorycytokines and other related factors between the two groups before treatment(P>0.05).After 6 cycles of treatment,the levels of immunoglobulin IgG,IgA,IgM,VEGF,LDH,β2-MG and the ratio of NK cells in the chemotherapy group were significantly lower than those before treatment(P<0.05),TNF-αand the ratio of Th17 cells was significantly higher than that those before treatment.The levels of IgG,IgA,IgM,VEGF,LDH andβ2-MG in the thalidomide group were significantly lower than those before treatment(P<0.05).The level of TNF-αand the Th17 cell,NK cell rate were significantly higher than those before treatment(P<0.05).In addition,the levels of IgG,IgA,IgM,VEGF,LDH andβ2-MG in the thalidomide group were significantly lower than those in the chemotherapy group(P<0.05),and the level of TNF-α,the rates of Th17 cells and NK cells were significantly higher than those in the chemotherapy group(P<0.05).Conclusion:Thalidomide combined with CHOP chemotherapy has a significant therapeutic effect on diffuse large B-cell lymphoma.Thalidomide combined with CHOP chemotherapy can significantly reduce the levels of angiogenesisVEGF,lactate dehydrogenase andβ2-MG in patients,significantly regulate the immune function of patients,and improve the Th17 cell rate and natural killer cell rate and the level of TNF-αin the body.This article provides the basis for the treatment of clinical diffuse large B cell lymphoma.