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放射性粒子植入治疗口腔癌过程中对生长分化因子及程序性死亡受体-1的影响

Significance of I radioactive seed implantation on growth differentiation factor and programmed death receptor-1 during treatment of oral cancer.

作者信息

Xue Gang, Feng Yao, Li Jia-Bin

机构信息

Department II of Prosthodontics, The Second Affiliated Hospital of Jiamusi University, Jiamusi 154000, Heilongjiang Province, China.

Department I of Endodontics, The Second Affiliated Hospital of Jiamusi University, Jiamusi 154000, Heilongjiang Province, China.

出版信息

World J Clin Cases. 2020 Mar 6;8(5):874-886. doi: 10.12998/wjcc.v8.i5.874.

Abstract

BACKGROUND

Oral cancer (OC) is the most common malignant tumor in the oral cavity, and is mainly seen in middle-aged and elderly men. At present, OC is mainly treated clinically by surgery or combined with radiotherapy and chemotherapy; but recently, more and more studies have shown that the stress trauma caused by surgery and the side effects of radiotherapy and chemotherapy seriously affect the prognosis of patients.

AIM

To determine the significance of I radioactive seed implantation on growth differentiation factor 11 (GDF11) and programmed death receptor-1 (PD-1) during treatment of OC.

METHODS

A total of 184 OC patients admitted to The Second Affiliated Hospital of Jiamusi University from May 2015 to May 2017 were selected as the research subjects for prospective analysis. Of these patients, 89 who received I radioactive seed implantation therapy were regarded as the research group (RG) and 95 patients who received surgical treatment were regarded as the control group (CG). The clinical efficacy, incidence of adverse reactions and changes in GDF11 and PD-1 before treatment (T0), 2 wk after treatment (T1), 4 wk after treatment (T2) and 6 wk after treatment (T3) were compared between the two groups.

RESULTS

The efficacy and recurrence rate in the RG were better than those in the CG ( < 0.05), while the incidence of adverse reactions and survival rate were not different. There was no difference in GDF11 and PD-1 between the two groups at T0 and T1, but these factors were lower in the RG than in the CG at T2 and T3 ( < 0.05). Using receiver operating characteristic (ROC) curve analysis, GDF11 and PD-1 had good predictive value for efficacy and recurrence ( < 0.001).

CONCLUSION

I radioactive seed implantation has clinical efficacy and can reduce the recurrence rate in patients with OC. This therapy has marked potential in clinical application. The detection of GDF11 and PD-1 in patients during treatment showed good predictive value for treatment efficacy and recurrence in OC patients, and may be potential targets for future OC treatment.

摘要

背景

口腔癌(OC)是口腔最常见的恶性肿瘤,主要见于中老年男性。目前,OC临床主要通过手术或联合放疗及化疗进行治疗;但近年来,越来越多的研究表明,手术造成的应激创伤以及放疗和化疗的副作用严重影响患者预后。

目的

确定¹²⁵I放射性粒子植入在OC治疗过程中对生长分化因子11(GDF11)和程序性死亡受体1(PD-1)的影响。

方法

选取2015年5月至2017年5月佳木斯大学附属第二医院收治的184例OC患者作为前瞻性分析的研究对象。其中,89例接受¹²⁵I放射性粒子植入治疗的患者作为研究组(RG),95例接受手术治疗的患者作为对照组(CG)。比较两组的临床疗效、不良反应发生率以及治疗前(T0)、治疗后2周(T1)、治疗后4周(T2)和治疗后6周(T3)时GDF11和PD-1的变化。

结果

RG的疗效和复发率优于CG(P<0.05),而不良反应发生率和生存率无差异。两组在T0和T1时GDF11和PD-1无差异,但在T2和T3时RG中的这些因子低于CG(P<0.05)。采用受试者工作特征(ROC)曲线分析,GDF11和PD-1对疗效和复发具有良好的预测价值(P<0.001)。

结论

¹²⁵I放射性粒子植入具有临床疗效,可降低OC患者的复发率。该疗法在临床应用中具有显著潜力。治疗期间检测患者的GDF11和PD-1对OC患者的治疗疗效和复发具有良好的预测价值,可能是未来OC治疗的潜在靶点。

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