手术联合^(125)I粒子治疗口腔涎腺腺样囊性癌患者可能作用机制分析

The Possible Mechanism of Surgery Combined with ^(125)I Brachytherapy for Patients with Oral Salivary Adenoid Cystic Carcinoma

目的:探讨手术联合^(125)I粒子近距离置入治疗对口腔涎腺腺样囊性癌(ACC)患者相关生长因子及临床疗效的影响。方法:选择2016年4月至2018年3月收治的符合条件的ACC患者80例,采用随机数字表法分为观察组41例和对照组39例。对照组行单纯手术治疗,观察组采用手术联合^(125)I粒子近距离置入治疗。随访3年,比较两组临床疗效;治疗前、治疗6个月,采用酶联免疫法检测血清血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFEG)、基质金属蛋白酶-9(MMP-9)含量。结果:随访3年,与对照组比较,观察组ACC患者缓解率、控制率高于对照组,差异有统计学意义(82.93%vs 58.97%,92.86%vs 74.36%)(χ^(2)=5.598,4.932,P<0.05)。治疗6个月,与对照组比较,观察组ACC患者血清VEGF、bFEG、MMP-9含量低于对照组,差异有统计学意义[(238.54±36.25 vs 266.46±32.23)pg/m,(215.42±34.25 vs 276.26±36.12)pg/mL,(493.24±24.36 vs 524.12±30.43)pg/mL](t=3.634,7.732,5.023,P<0.05)。结论:手术联合^(125)I粒子治疗有助于提高ACC患者临床疗效,其作用机制可能与降低血清VEGF、bFEG、MMP-9含量有关。

Objective:To study the related growth factors and clinical efficacy of surgery combined ^(125)I brachytherapy patients with nts with oral salivary adenoid cystic carcinoma(ACC).Methods:86 patients with ACC from April 2016 to March 2018 were divided into observation group(41 cases)and control group(39 cases).The control group had surgery,and the observation group had surgery combined with ^(125)I brachytherapy.The clinical efficacy were compared between two groups in the three-year follow-up.Before treatment and 6 months after treatment,serum related growth factors were compared between two groups.Results:In the three-year follow-up,the observation group remission rate and control rate were higher than those of the control group(82.93%vs 58.97%,92.86%vs 74.36%)(χ^(2)=5.598,4.932,P<0.05).6 months after therapy,observation group had serum VEGF,bFEG,MMP-9 lower than control group[(238.54±36.25 vs 266.46±32.23)pg/m,(215.42±34.25 vs 276.26±36.12)pg/mL,(493.24±24.36 vs 524.12±30.43)pg/mL](t=3.634,7.732,5.023,P<0.05).Conclusion:Surgery combined with ^(125)I brachytherapy can improve clinical efficacy of ACC patients,and its mechanism may be related to reducing serum VEGF,BFEG and MMP-9.