西妥昔单抗联合DP化疗方案对食管癌术后患者Th17/Treg免疫平衡及NF-κB蛋白含量的影响

Effect of cetuximab combined with DP chemotherapy regimen on Th17/Treg immune balance and NF-κB protein content after surgery for oesophageal cancer

目的研究西妥昔单抗联合DP化疗方案对食管癌术后患者辅助性T细胞17(Th17)/调节性T淋巴细胞(Treg)免疫平衡及核因子-κB(NF-κB)蛋白含量的影响。方法队列研究。抽取2020年8月至2023年6月安阳市肿瘤医院收治的120例食管癌术后患者,按随机数字表法分为对照组与研究组,每组60例。对照组给予DP化疗方案(多西他赛+顺铂)治疗,研究组在化疗基础上联合西妥昔单抗治疗。比较两组的治疗效果、Th17/Treg免疫平衡、NF-κB蛋白含量、Karnofsky功能状态(KPS)评分及不良反应发生情况。结果研究组有效率(63.33%,38/60)高于对照组(43.33%,26/60),P<0.05。治疗后,两组Th17、Treg百分比、Th17/Treg低于治疗前(P<0.05),且研究组低于对照组(P<0.05)。治疗后,两组p50、p65蛋白含量低于治疗前(P<0.05),且研究组低于对照组(P<0.05)。治疗后,两组KPS评分高于治疗前,且研究组高于对照组(P<0.05)。研究组Ⅰ~Ⅱ级恶心呕吐发生率(36.67%,22/60)高于对照组(20.00%,12/60),P<0.05;两组Ⅲ~Ⅳ级恶心呕吐及白细胞下降、血小板减少发生率比较差异未见统计学意义(P>0.05)。结论西妥昔单抗联合DP化疗方案能有效调控体内NF-κB蛋白表达,纠正Th17/Treg免疫紊乱,提高患者生存质量,可作为临床治疗首选方案之一。

Objective To investigate the effect of cetuximab combined with DP chemotherapy(docetaxel+cisplatin)regimen on T help-17(Th17)/regulatory T cells(Treg)immune balance and nuclear factor-κB(NF-κB)protein content after surgery for oesophageal cancer.Methods This study was a cohort trial.One hundred and twenty patients with esophageal cancer treated in Anyang Cancer Hospital from August 2020 to June 2023 were selected,and they were divided into the control group and the study group using random number table method,with 60 cases in each group.The control group was treated by DP chemotherapy regimen(docetaxel+cisplatin),while the study group was treated by cetuximab in addition to chemotherapy.The clinical efficacy,Th17/Treg immune balance,NF-κB protein content,Karnofsky performance status(KPS)score and incidence of adverse reactions were compared between the two groups.Results The overall efficacy rate in the study group(63.33%,38/60)was higher than that in the control group(43.33%,26/60),P<0.05.After treatment,the percentage of Th17,Treg,and Th17/Treg in both groups were lower than those before treatment(P<0.05),and the indexes in the study group were lower than those in the control group(P<0.05).After treatment,the levels of p50 and p65 in both groups were lower than those before treatment(P<0.05),and the levels in the study group were lower than those in the control group(P<0.05).After treatment,the KPS score of both groups were higher than those before treatment,and the KPS score of the study group was higher than that of the control group(P<0.05).The incidence of gradeⅠ~Ⅱtoxicities nausea and vomiting in the study group(36.67%,22/60)was higher than that in the control group(20.00%,12/60),P<0.05;there was no statistically significant difference in the incidence of gradeⅢ~Ⅳnausea,vomiting,leukopenia,and thrombocytopenia between the two groups(P>0.05).Conclusions Application of cetuximab combined with DP chemotherapy regimen after surgery for oesophageal cancer can effectively regulate the expression of NF-κB protein in vivo,correct Th17/Treg imbalance,and improve the quality of life of patients,which can be used as one of the preferred clinical treatment options.