六神丸联合放疗治疗食管癌的临床观察及对食管癌炎性微环境与血管生成的作用机制研究

发布时间：2019-04-02 19:38

【摘要】：目的：观察六神丸联合放疗治疗食管癌的近期疗效、不良反应、生活质量改善情况及对食管癌炎性微环境与血管生成的作用及其相关机制。方法：(1)临床观察：将30例食管癌患者分为实验组和对照组,对照组采用单纯放射治疗,实验组采用六神丸配合放疗进行治疗。一个疗程后,评价两组近期疗效、生活质量改善情况、不良反应。 (2)实验研究：采用皮下注射食管癌细胞悬液建立食管癌移植瘤裸鼠模型,并予以六神丸干预食管癌移植瘤裸鼠模型,动态观察各组裸鼠生存情况、瘤体生长情况、病理组织学观察,绘制瘤体生长曲线,计算抑瘤率,采用RT-PCR法和Western-blot测定瘤组织肿瘤坏死因子一α(TNF-α)、白介素-6(IL-6)、核转录因子一KB(NF-κKB)、血管内皮生长因子(VEGF)水平,免疫组织化学方法测定肿瘤微血管密度(MVD)。结果：(1)临床观察：两组患者在近期疗效比较上无显著差异,但是实验组较对照组生活质量改善情况明显,且在不良反应的发生率上明显低于对照组。 (2)实验研究：六神丸能在一定程度上抑制食管癌移植瘤的生长,六神丸高、中、低剂量组抑瘤率与模型组比较,明显高于模型组,差异有统计学意义(P0.05)；各六神丸组食管癌移植瘤组织内TNF-α、IL-6、NF-κB表达活性较模型组明显下调。各六神丸组食管癌移植瘤组织内VEGF、MVD表达活性明显低于模型组。结论：(1)临床研究：六神丸联合放疗方案虽不能提高食管癌患者近期疗效,但与单纯放疗比较,能显著改善患者生活质量,降低不良反应的发生。 (2)实验研究：1)六神丸能抑制食管癌移植瘤的生长；2)六神丸通过下调食管癌炎性微环境中TNF-α、IL-6、NF-κB的表达,调节TNF-α--NF-KB通路,可能是其抗肿瘤机制之一。3)六神丸能通过调节瘤组织内VEGF、MVD的表达活性,抑制血管生成是其抗肿瘤机制之一。4)六神丸通过调节肿瘤炎性微环境中TNF-α--NF-κKB通路,调控VEGF表达,抑制肿瘤血管生成,可能是其抗肿瘤机制之一。
[Abstract]:Aim: to observe the short-term efficacy, adverse reactions, improvement of quality of life (QOL) and the effect on inflammatory microenvironment and angiogenesis of esophageal carcinoma treated with Liushen pill combined with radiotherapy. Methods: (1) Clinical observation: 30 patients with esophageal cancer were divided into experimental group and control group. The control group was treated with radiotherapy alone, and the experimental group was treated with Liushen pill combined with radiotherapy. After a course of treatment, we evaluated the short-term efficacy, improvement of quality of life and adverse reactions between the two groups. (2) Experimental study: the nude mice model of transplanted esophageal carcinoma was established by subcutaneous injection of esophageal cancer cell suspension, and the nude mice model of transplanted esophageal carcinoma was treated with Liushen Pill, and the survival and the growth of tumor were observed dynamically in each group of nude mice. The tumor growth curve was drawn and the tumor inhibition rate was calculated. The tumor necrosis factor-伪 (TNF- 伪), interleukin-6 (IL-6) and nuclear factor-KB (NF- 魏 KB) in tumor tissue were measured by RT- PCR and Western-blot. The level of vascular endothelial growth factor (VEGF) and the detection of tumor microvessel density (MVD).) by immunohistochemical method Results: (1) Clinical observation: there was no significant difference in the short-term curative effect between the two groups, but the quality of life in the experimental group was better than that in the control group, and the incidence of adverse reactions in the experimental group was significantly lower than that in the control group. (2) Experimental study: Liushen pill can inhibit the growth of transplanted tumor of esophageal cancer to a certain extent, high, middle and low dose of Liushen pill compared with the model group, the inhibition rate is significantly higher than the model group, the difference is statistically significant (P0.05); Compared with the model group, the expression of TNF- 伪 and IL-6,NF- 魏 B in the transplanted tumor tissue of esophageal carcinoma were significantly down-regulated in each six-shenwan group. The expression of VEGF,MVD in the transplanted tumor tissue of esophageal carcinoma was significantly lower than that in the model group. Conclusion: (1) Clinical study: although Liushen pill combined with radiotherapy can not improve the short-term efficacy of esophageal cancer patients, compared with radiotherapy alone, it can significantly improve the quality of life and reduce the occurrence of adverse reactions. (2) Experimental study: 1) Liushen pill can inhibit the growth of transplanted tumor of esophageal cancer; 2) Liushen Pill can regulate the expression of TNF- 伪 and IL-6,NF- kappa B in inflammatory microenvironment of esophageal cancer and regulate the TNF- 伪-NF-KB pathway, which may be one of its anti-tumor mechanisms. 3) Liushen Pill can regulate VEGF, in tumor tissue by regulating the expression of TNF 伪 and VEGF, kappa B in the inflammatory microenvironment of esophageal cancer. The expression of MVD and the inhibition of angiogenesis are one of its anti-tumor mechanisms. 4) Liushen Pill regulates the expression of VEGF and inhibits tumor angiogenesis by regulating the TNF- 伪-NF- kappa KB pathway in inflammatory microenvironment of tumor. It may be one of its anti-tumor mechanisms.
【学位授予单位】：湖南中医药大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R735.1

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