董瑛　施英　沈建平

[摘要] 目的 观察香菇多糖联合GP化疗方案治疗晚期非小细胞肺癌客观反应率，分析对外周血促炎性细胞因子IL-1β、IL-6和TNF-α表达的影响及意义。 方法 将52例晚期非小细胞肺癌患者根据治疗方案的不同随机分为两组：对照组（GP化疗方案）和观察组（香菇多糖联合GP化疗方案），各26例。比较两组患者经8周治疗后客观反应率和促炎性细胞因子IL-1β、IL-6和TNF-α蛋白表达水平的差异。 结果 与对照组相比，观察组患者对香菇多糖联合GP化疗方案反应率明显提高（P<0.05）；同样，观察组促炎性细胞因子IL-1β和TNF-α表达水平明显下降（P<0.05）。 结论 香菇多糖联合GP化疗方案治疗晚期非小细胞肺癌可以有效提高客观反应率，并与抑制外周血促炎性细胞因子IL-1β和TNF-α的表达相关。

[关键词] 香菇多糖；GP化疗方案；晚期非小细胞肺癌；IL-1β；IL-6；TNF-α

[中图分类号] R734.2 [文献标识码] A [文章编号] 1673-9701（2017）03-0018-04

Recent efficacy of lentinan combined with GP chemotherapy in the treatment of advanced non-small cell lung cancer and on the expression of proinflammatory cytokines IL-1β， IL-6 and TNF-α in peripheral blood

DONG Ying1 SHI Ying1 SHEN Jianping2

1.Department of Pharmacy， Hangzhou Red Cross Hospital， Hanghzou 310003， China； 2.Department of Hematology， Zhejiang Traditional Chinese Medicine Hospital， Hanghzou 310003， China

[Abstract] Objective To observe the objective response rate of Lentinan combined with GP chemotherapy in treatment of advanced non-small cell lung cancer and to analyze its effect and significance on the expression of proinflammatory cytokines IL-1β， IL-6 and TNF-αin peripheral blood. Methods A total of 52 patients with advanced non-small cell lung cancer were randomly divided into two groups including the control group （GP chemotherapy regimen） and the observation group（lentinan combined with GP chemotherapy regimen） according to the different treatment regimens， with 26 cases in each group. The differences in the objective response rate and the expression levels of proinflammatory cytokines IL-1β， IL-6 and TNF-αwere compared between the two groups after 8 weeks of treatment. Results Compared with the control group， the response rate of lentinan combined with GP regimen was significantly improved in the observation group. Similarly， the expression of proinflammatory cytokines IL-1β and TNF-α in the observation group decreased significantly. Conclusion Lentinan combined with GP regimen in the treatment of advanced non-small cell lung cancer can effectively improve the objective response rate and inhibit the expression of proinflammatory cytokines IL-1β and TNF-α in peripheral blood.

[Key words] Lentinan； GP chemotherapy； Advanced non-small cell lung cancer； IL-1β； IL-6； TNF-α

肺癌是世界上最常見的恶性肿瘤之一，与多种因素相关（包括遗传、环境、电离辐射、吸烟以及既往肺部感染等因素）。其中，非小细胞肺癌是肺癌表现的主要类型，约占肺癌的80%，据我国2015年全国肿瘤登记中心数据报道，肺癌的发生率及死亡率位居所有肿瘤的首位[1]。随着治疗经验的积累以及生物学特征了解的加深，越来越多的靶向治疗药物被推荐用于特定类型晚期非小细胞肺癌的治疗[2]。但对于大部分的晚期非小细胞肺癌患者来说，含铂化疗仍然是其标准治疗手段，其中GP化疗方案[吉西他滨（Gemcitabine）+顺铂（Cisplatin）]是标准治疗方案之一。Yin X等[3]通过Meta分析报道了香菇多糖联合GP化疗方案能够明显提高近期疗效和减少化疗相关的不良反应。由于Meta分析纳入研究较少等原因而存在较大偏倚，故存在继续研究报道的价值。香菇多糖是从香菇子实体中提取的有效活性成分，具有抑制多类肿瘤（结肠癌、膀胱癌）细胞增殖与生长，并应用于胃癌的临床治疗[4-6]。……