清宫排毒汤治疗宫颈癌疗效及对患者肿瘤细胞上皮间质转化的影响

Effect of Qinggong Paidu decoction on the treatment of cervical cancer and its impact on the epithelial-mesenchymal transformation of tumor cells

目的:观察清宫排毒汤治疗宫颈癌的疗效及其对患者肿瘤细胞上皮间质转化基因表达的影响。方法:选取108例宫颈癌患者纳入研究,将入选患者划分为常规组与治疗组,常规组给予单纯化学药物治疗(化疗),治疗组在化疗基础上应用清宫排毒汤治疗。治疗3个化疗周期后,比较两组临床疗效;观察两组患者治疗前后中医症候积分,血清肿瘤标志物:癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCCA)、糖类抗原125(CA125),辅助T细胞(Th)1/Th2细胞因子:γ-干扰素(IFN-γ)、白细胞介素(IL)-4、IL-2、IL-6,上皮间质转化基因:Vimentin、N-cadherin、E-cadherin、α-catenin的mRNA表达量的变化情况;统计两组治疗期间不良反应发生率。结果:治疗组总有效率为81.48%,常规组为62.96%,治疗组高于常规组(P<0.05);治疗组整体疗效水平优于常规组(P<0.05)。宫颈癌组织中Vimentin、N-cadherin基因mRNA表达量均高于本组正常宫颈组织(均P<0.05),E-cadherin、α-catenin基因mRNA表达量均低于本组正常宫颈组织(均P<0.05);治疗组Vimentin、N-cadherin基因mRNA表达量均低于常规组(均P<0.05),E-cadherin、α-catenin基因mRNA表达量均高于常规组(均P<0.05)。治疗前两组患者中医症候积分、血清肿瘤标志物水平、Th1/Th2细胞因子水平比较,差异无统计学意义(均P>0.05);治疗后,两组患者中医症候积分,血清CEA、SCCA、CA125水平,IL-4、IL-6水平均较本组治疗前下降(均P<0.05),治疗组均低于常规组(均P<0.05);IFN-γ、IL-2较本组治疗前均升高(均P<0.05),治疗组均高于常规组(均P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:清宫排毒汤佐治宫颈癌可提高临床疗效,能够通过降低血清肿瘤标志物与调节Th1/Th2细胞因子表达发挥阻止或延缓肿瘤细胞上皮间质转化的作用。

Objective:To observe the curative effect of Qinggong Paidu decoction on the expression of epithelial-mesenchymal transformation gene in patients with cervical cancer.Methods:A total of 108 cases of cervical cancer patients were divided into the conventional treatment group and the treatment group.Patients in the conventional treatment group were given simple chemical drug therapy(chemotherapy),and those in the treatment group were administered with Qinggong Paidu decoction on the basis of chemotherapy.After 3 cycles of chemotherapy,the clinical efficacy of the two groups was compared.Furthermore,the traditional Chinese medicine(TCM)syndrome integral,serum tumor markers of carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCCA),carbohydrate antigen 125(CA 125),T helper cell(Th)1/Th2 cytokines,γ-interferon(IFN-γ),interleukin(IL)-4,IL-2,IL-6,epithelial mesenchymal transforming genes of Vimentin,N-cadherin,E-cadherin andα-catenin changes at mRNA expression levels were compared in the two groups of patients before and after treatment.In addition,the incidence of adverse reactions was calculated during treatment in the two groups.Results:The total effective rate was 81.48%in the treatment group and 62.96%in the conventional treatment group,and the treatment group was higher than the conventional treatment group(P<0.05).The overall efficacy of the treatment group was better than that of the conventional treatment group(P<0.05).The mRNA expression levels of Vimentin and N-cadherin genes in cervical cancer tissues were all higher than that in normal cervical tissues of this group(all P<0.05),while those of E-cadherin andα-c atenin genes were all lower than that in normal cervical tissues of this group(all P<0.05).Besides,the mRNA expression levels of Vimentin and N-cadherin genes in the treatment group were lower than those in the conventional treatment group(all P<0.05),and those of E-cadherin andα-catenin genes were higher than those in the conventional treatment group(all P<0.05).There were no statistically significant differences in TCM syndrome scores,serum tumor markers,and Th1/Th2 cytokine levels between the two groups before treatment(P>0.05).After treatment,TCM syndrome scores,serum CEA,SCCA and CA 125 levels,IL-4 and IL-6 levels in both groups were all lower than those before treatment(all P<0.05),and the treatment group was lower than the conventional treatment group(P<0.05).Furthermore,the levels of IFN-γand IL-2 in the treatment group were higher than those in the conventional treatment group(all P<0.05).Besides,there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The Qinggong Paidu decoction can improve the clinical efficacy for the treatment of cervical cancer and play a role in preventing or delaying epithelial-mesenchymal transformation of tumor cells by reducing serum tumor markers and regulating the expression of Th1/Th2 cytokines.