晚期鼻咽癌调强放疗同步TP方案前后的血清前梯度蛋白表达水平及其疗效预测价值

doi:10.3969/j.issn.1007-3205.2024.07.003

河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (7): 756-760.doi: 10.3969/j.issn.1007-3205.2024.07.003

晚期鼻咽癌调强放疗同步TP方案前后的血清前梯度蛋白表达水平及其疗效预测价值

1.河北省保定市第二中心医院输血科，河北保定 072750；2.河北省保定市第二中心医院检验科，河北保定 072750

出版日期:2024-07-25 发布日期:2024-07-18
作者简介:韩明明（1990-），女，河北保定人，河北省保定市第二中心医院主管检验师，医学学士，从事临床检验研究。
基金资助:
保定市科技计划项目（2141ZF163）

Serum AGR2 expression and its predictive value for efficacy in advanced nasopharyngeal carcinoma patients treated with IMRT combined with TP regimen

1.Department of Transfusion, the Second Central Hospital of Baoding City, Hebei Province, Baoding
072750, China; 2.Department of Clinical Laboratory, the Second Central Hospital of
Baoding City, Hebei Province, Baoding 072750, China

Online:2024-07-25 Published:2024-07-18

摘要/Abstract

摘要： 目的探究调强放疗（intensive modulated radiation therapy,IMRT）联合同步TP方案（紫杉醇，顺铂）治疗晚期鼻咽癌前后血清前梯度蛋白2（anterior gradient-2，AGR2）水平的变化及其对疗效的预测价值。
方法选取晚期鼻咽癌患者51例，给予TP化疗方案同步IMRT放疗，共4个周期。记录、比较同步放化疗过程中的毒性反应，治疗结束后的近期和远期疗效。同时选择健康人30例作为对照组，观察治疗前后血清AGR2水平变化对晚期鼻咽癌患者预后的影响。
结果同步放化疗后，晚期鼻咽癌患者的总有效率为80.39%，其中完全缓解41.18%，部分缓解39.22%；不良反应主要为口咽部损害（90.2%）、骨髓抑制（74.5%）、白细胞减少（68.6%）、血小板减少（33.3%）等。同步放化疗后，患者血清AGR2水平显著降低，但仍明显高于正常对照组水平［（13.28±4.17 ）μg/L vs. (8.85±1.98)μg/L，P＜0.001］，其中有效组的血清AGR2水平较治疗前呈现显著下降趋势（13.28 μg/L vs. 24.18 μg/L，P＜0.05），而无效组治疗前（33.81±8.12）μg/L与治疗后（24.77±6.93）μg/L差异无统计学意义。Kaplan-Meier曲线显示，相比AGR2高水平组，低水平组患者治疗后中位生存时间明显延长且预后更好（35.24个月vs. 31.73个月，P=0.039）。
结论 IMRT同步TP方案治疗晚期鼻咽癌患者有效组中AGR2水平显著降低，同时AGR2低表达患者预后更好。

关键词: 鼻咽癌, 化放疗, 前梯度蛋白

Abstract: Objective To investigate the changes of serum anterior gradient-2 (AGR2) before and after intensive modulated radiation therapy (IMRT) combined with simultaneous TP regimen (paclitaxel, cisplatin) in patients with advanced nasopharyngeal carcinoma (NPC) and its predictive value.
Methods A total of 51 patients with advanced NPC were treated with TP chemotherapy and IMRT radiotherapy for 4 cycles. The toxic reactions during simultaneous radiotherapy and chemotherapy and the short-term and long-term effects after treatment were recorded and compared. In the meantime, 30 healthy people were selected as the control group to observe the effect of serum AGR2 level on the prognosis of patients with advanced NPC before and after treatment.
Results After simultaneous radiotherapy and chemotherapy, the total effective rate of patients with advanced NPC was 80.39%, of which complete remission (CR) was 41.18% and partial remission (PR) was 39.22%. The main adverse reactions were oropharyngeal damage (90.2%), myelosuppression (74.5%), leukopenia (68.6%), and thrombocytopenia (33.3%). After simultaneous radiotherapy and chemotherapy, the serum AGR2 level of the patients decreased significantly, which, however, was still significantly higher than that of the normal control group ［(13.28±4.17) μg/L vs. ( 8.85±1.98) μg/L］(P＜0.001). The serum AGR2 level of the effective group was significantly lower than that before treatment (13.28 μg/L vs. 24.18 μg/L) (P＜0.05). There was no significant difference between the ineffective group before treatment ［(33.81±8.12) μg/L］ and after treatment ［(24.77±6.93) μg/L］. The Kaplan-Meier curve showed that the median survival time of the patients in the low level AGR2 group was significantly longer and the prognosis was better than that in the high level AGR2 group (35.24 months vs. 31.73 months, P=0.039).
Conclusion The level of AGR2 in the effective group of patients with advanced NPC treated with IMRT and TP regimen is significantly lower, and the prognosis of patients with low expression of AGR2 is better.

Key words: nasopharyngeal carcinoma, chemoradiotherapy, anterior gradient-2

韩明明1, 王丽丽1, 张鹏举1, 姚伟莉1, 袁静1, 张玲2. 晚期鼻咽癌调强放疗同步TP方案前后的血清前梯度蛋白表达水平及其疗效预测价值 [J]. 河北医科大学学报, 2024, 45(7): 756-760.

HAN Ming-ming1, WANG Li-li1, ZHANG Peng-ju1, YAO Wei-li1, YUAN Jing1, ZHANG Ling2. Serum AGR2 expression and its predictive value for efficacy in advanced nasopharyngeal carcinoma patients treated with IMRT combined with TP regimen [J]. Journal of Hebei Medical University, 2024, 45(7): 756-760.

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晚期鼻咽癌调强放疗同步TP方案前后的血清前梯度蛋白表达水平及其疗效预测价值

Serum AGR2 expression and its predictive value for efficacy in advanced nasopharyngeal carcinoma patients treated with IMRT combined with TP regimen

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