消瘤方对弥漫大B细胞淋巴瘤肿瘤微环境及miR-532-3p表达的影响

Effect of Xiaoliu Forluma on tumor microenvironment and miR-532-3p expression in diffuse large B-cell lymphoma

目的:观察消瘤方治疗弥漫大B细胞淋巴瘤(DLBCL)的临床疗效及对细胞因子、miR-532-3p、β-连环蛋白mRNA(β-catenin mRNA)表达的影响。方法:纳入DLBCL患者60例,随机分为对照组和治疗组,每组各30例;同时,纳入15例健康志愿者作为正常组。对照组患者给予常规的R-CHOP化疗方案治疗,治疗组患者在对照组治疗基础上联合消瘤方加减口服,两组疗程均为4个化疗周期。评价两组患者的临床疗效、中医证候疗效,检测所有纳入受试者的血清白介素(IL)-2、IL-4、IL-6、IL-10及外周血淋巴细胞miR-532-3p、β-catenin mRNA的表达水平。结果:①治疗后,治疗组的临床总有效率为93.3%,对照组为80.0%,治疗组的疗效优于对照组(P<0.05)。②治疗后,治疗组的中医证候疗效总有效率为96.7%,对照组为83.3%,治疗组的中医证候疗效优于对照组(P<0.01)。③与正常组比较,两组患者治疗前的miR-532-3p表达水平均显著降低(P<0.01)、β-catenin mRNA表达水平均显著升高(P<0.01);治疗后,两组患者的miR-532-3p表达水平均升高(P<0.01)、β-catenin mRNA表达水平均降低(P<0.01),且治疗组患者的miR-532-3p表达水平高于对照组(P<0.01)、β-catenin mRNA表达水平低于对照组(P<0.01)。④与正常组比较,两组患者治疗前的IL-4、IL-6、IL-10水平均显著升高(P<0.01),IL-2水平均显著降低(P<0.01);治疗后,两组患者的IL-4、IL-6、IL-10水平均明显降低(P<0.01),IL-2水平均明显升高(P<0.01),且治疗组患者的IL-4、IL-6、IL-10水平低于对照组(P<0.05),IL-2水平高于对照组(P<0.05)。结论:消瘤方联合化疗治疗DLBCL,能有效抑制肿瘤,改善临床症状和肿瘤微环境,其作用机制可能与调节miR-532-3p、β-catenin m RNA的表达有关。

Objective:To observe the clinical efficacy of Xiaoliu Forluma in the treatment of diffuse large B-cell lymphoma(DLBCL)and its influence on the expressions of cytokines,miR-532-3p andβ-catenin mRNA.Methods:Sixty patients of DLBCL were included and randomly divided into the control group and treatment group,30 cases in each group.Meanwhile,15 healthy volunteers were included as the normal group.The patients in the control group were treated with routine R-CHOP chemotherapy,and the patients in the treatment group were treated with modified Xiaoliu Forluma orally based on the treatment of the control group.The treatment course of both groups was 4 chemotherapy cycles.The clinical efficacy and the efficacy of traditional Chinese medicine syndrome in both groups were evaluated.The levels of serum interleukin(IL)-2,IL-4,IL-6 and IL-10 and the expression levels of miR-532-3p andβ-catenin mRNA in peripheral blood lymphocyte of all the subjects were detected.Results:①After treatment,the total clinical effective rate was 93.3%in the treatment group and 80.0%in the control group,and the effect of the treatment group was superior to that in the control group(P<0.05).②After treatment,the total effective rate on traditional Chinese medicine syndrome was 96.7%in the treatment group and 83.3%in the control group,and the traditional Chinese medicine syndrome effect of the treatment group was superior to those in the control group(P<0.01).③Compared with the normal group,the expression level of miR-532-3p in the two groups before treatment was significantly decreased(P<0.01),and the expression level ofβ-catenin mRNA was significantly increased(P<0.01).After treatment,the expression level of miR-532-3p in the two groups was increased(P<0.01),the expression level ofβ-catenin mRNA was decreased(P<0.01),and the expression level of miR-532-3p in the treatment group was higher than that in the control group(P<0.01),the expression level ofβ-catenin mRNA was lower than that in the control group(P<0.01).④Compared with the normal group,the levels of IL-4,IL-6 and IL-10 in the two groups before treatment were significantly increased(P<0.01),and the level of IL-2 was significantly decreased(P<0.01).After treatment,the levels of IL-4,IL-6 and IL-10 in the two groups were significantly decreased(P<0.01),the level of IL-2 was significantly increased(P<0.01),and the levels of IL-4,IL-6 and IL-10 in the treatment group were lower than those in the control group(P<0.05),the level of IL-2 was higher than that in the control group(P<0.05).Conclusion:Xiaoliu Formula combined with chemotherapy can effectively inhibit the tumor and improve the clinical symptoms and the tumor microenvironment,and its mechanisms may be related to regulating the expression of miR-532-3p andβ-catenin mRNA.