华蟾素胶囊对中晚期非小细胞肺癌手术患者血清基质金属蛋白酶、自噬相关蛋白水平的影响

Effect of cinobufacini capsule on serum levels of matrix metalloproteinases and autophagy-related proteins in patients with advanced non-small cell lung cancer undergoing surgery

摘要:

目的 探讨华蟾素胶囊对中晚期肺癌手术患者血清基质金属蛋白酶（MMP）、自噬相关蛋白水平的影响。方法 选取2017年9月—2021年4月成都医学院第二附属医院就诊的中晚期非小细胞肺癌（NSCLC）患者108例，将患者分为对照组和研究组，各54例。患者均接受肺癌根治术，对照组术后采取常规化疗，研究组在对照组基础上加用华蟾素胶囊。比较两组患者临床疗效、免疫功能、血清肿瘤标志物、血清MMP和自噬相关蛋白、不良反应等指标。结果 研究组治疗后客观缓解率高于对照组（P <0.05）。研究组治疗前后CD3⁺、CD4⁺下降程度，CD8⁺升高程度小于对照组。（P <0.05）。研究组患者治疗前后糖类抗原125、癌胚抗原、神经元特异性烯醇化酶的下降程度大于对照组（P <0.05）。研究组治疗前后基质金属蛋白酶2、基质金属蛋白酶9下降程度，自噬相关蛋白1、微管相关蛋白1轻链3-Ⅱ升高程度大于对照组（P <0.05）。两组患者血小板减少、肝功能损伤、白细胞减少、恶心呕吐发生率比较，差异无统计学意义（P >0.05）。结论 华蟾素胶囊可有效提高中晚期肺癌手术患者辅助治疗的疗效，改善免疫功能和血清肿瘤标志物水平，抑制MMP水平，提高细胞自噬活性，且未增加不良反应。

Abstract:

Objective To explore the effect of the cinobufacini capsule on the serum levels of matrix metalloproteinases (MMP) and autophagy-related proteins in patients with advanced non-small cell lung cancer (NSCLC) undergoing surgery.Methods A total of 108 NSCLC patients visiting our hospital from September 2017 to April 2021 were included in this study and divided into control and study groups according to the randomized number table method. Both groups received radical resection of lung cancer. The control group was given conventional chemotherapy postoperatively, and the study group was additionally given the cinobufacini capsules on the basis of conventional chemotherapy. The clinical efficacy, immune function, serum tumor markers, MMP, and autophagy-related proteins, and adverse reactions were compared between the two groups.Results The objective response rate (ORR) was significantly higher in study group than that in control group (P < 0.05). After the treatment, the decreases in the frequencies of CD3⁺ and CD4⁺ lymphocytes and the increase in the frequency of CD8⁺ lymphocytes in the study group were higher than those in the control group (P < 0.05). The decreases in the levels of carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA) and neuron specific enolase (NSE) after the treatment in the study group were greater than those in the control group (P < 0.05). Besides, the decreases in the levels of matrix metalloproteinase-2 (MMP-2) and MMP-9, as well as the increases in the levels of autophagy-related protein 1, microtubule-associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ), were greater in the study group than those in the control group after the treatment (P < 0.05). There was no significant difference in the incidence of thrombocytopenia, liver function damage, leukopenia and nausea and vomiting between the two groups (P > 0.05).Conclusions Cinobufacini capsule is effective as an auxiliary therapy. It improves the immune function and the levels of serum tumor markers, reduces the levels of MMP, and enhances the autophagic activity of cells without increasing the incidence of adverse reactions.