盐酸小檗碱联合表柔比星、顺铂对晚期子宫内膜癌的抗肿瘤效果

摘要/Abstract

摘要：

目的观察盐酸小檗碱联合表柔比星、顺铂对晚期子宫内膜癌(EC)的抗肿瘤效果。方法选取2016年1月至2018年12月安徽医科大学附属巢湖医院收治的120例晚期EC患者,采用随机数表法将其分为试验组和对照组,各60例。对照组给予静脉滴注表柔比星、顺铂注射液,试验组在对照组治疗基础上给予口服盐酸小檗碱治疗,21 d/周期,共6周期。统计并对比两组临床疗效、血清肿瘤标志物变化、不良反应发生率、1年死亡率。结果两组临床疗效等级分布比较,差异有统计学意义(Z=4.489,P=0.042),且试验组总有效率为63.33%(38/60),高于对照组的45.00%(27/60),差异有统计学意义(χ²=4.062,P=0.044)。治疗后试验组血清糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)水平分别为(30.01±6.05)U/ml、(40.38±7.61)U/ml、(16.85±3.08)ng/ml,对照组分别为(45.83±6.91)U/ml、(48.89±8.05)U/ml、(20.20±4.18)ng/ml,均较本组内治疗前降低,且治疗后试验组血清CA125、CA19-9、CEA水平均低于对照组,差异均有统计学意义(t=13.343,P<0.001;t=5.951,P<0.001;t=4.998,P<0.001)。治疗期间试验组肝功能异常、肾功能异常、白细胞减少、血小板减少、恶心/呕吐、腹泻、口腔黏膜炎发生率及不良反应总发生率分别为8.33%(5/60)、5.00%(3/60)、6.67%(4/60)、6.67%(4/60)、8.33%(5/60)、1.67%(1/60)、3.33%(2/60)、40.00%(24/60),对照组分别为6.67%(4/60)、3.33%(2/60)、8.33%(5/60)、6.67%(4/60)、8.33%(5/60)、0(0/60)、1.67%(1/60)、35.00%(21/60),差异均无统计学意义(χ²=0.000,P=1.000;χ²=0.000,P=1.000;χ²=0.000,P=1.000;χ²=0.134,P=0.714;χ²=0.109,P=0.741;P=1.000;χ²=0.000,P=1.000;χ²=0.320,P=0.572)。随访1年,对照组死亡率为8.33%(5/60),试验组死亡率为5.00%(3/60),两组差异无统计学意义(χ²=0.134,P=0.714)。结论盐酸小檗碱联合表柔比星、顺铂治疗晚期EC疗效显著,可降低血清肿瘤标志物水平,且安全可靠,值得临床借鉴。

关键词:子宫内膜肿瘤,盐酸小檗碱,肿瘤标志物

Abstract:

ObjectiveTo observe the anti-tumor effect of berberine hydrochloride combined with epirubicin and cisplatin on advanced endometrial carcinoma (EC).MethodsA total of 120 patients with advanced EC admitted to Chaohu Hospital of Anhui Medical University from January 2016 to December 2018 were enrolled. The patients were divided into experimental group and control group by random number table method, 60 cases in each group. The control group was given intravenous infusion of epirubicin and cisplatin. The experimental group was given oral berberine hydrochloride on the basis of control group treatment, 21 days/cycle for 6 cycles. The clinical efficacy, changes of serum tumor markers, incidence of adverse reactions, 1-year mortality rate of the two groups were counted and compared.ResultsThe distribution of clinical efficacy grades in the two groups was significantly different (Z=4.489,P=0.042), and the total effective rate of the experimental group was 63.33% (38/60), which was higher than that of 45.00% (27/60) in the control group (χ²=4.062,P=0.044). The levels of carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), carcino-embryonic antigen (CEA) in the experimental group after treatment were (30.01±6.05) U/ml, (40.38±7.61) U/ml and (16.85±3.08) ng/ml respectively, which in the control group were (45.83±6.91) U/ml, (48.89±8.05) U/ml and (20.20±4.18) ng/ml respectively. The levels of CA125, CA19-9, CEA in both groups after treatment decreased compare with those before treatment, which in the experimental group after treatment were lower than those in the control group, with statistically significant differences (t=13.343,P<0.001;t=5.951,P<0.001;t=4.998,P<0.001). The incidences of liver dysfunction, renal dysfunction, leukopenia, thrombocytopenia, nausea/vomiting, diarrhea, oral mucositis and total adverse reaction in the experimental group were 8.33% (5/60), 5.00% (3/60), 6.67% (4/60), 6.67% (4/60), 8.33% (5/60), 1.67% (1/60), 3.33% (2/60), 40.00% (24/60), which were 6.67% (4/60), 3.33% (2/60), 8.33% (5/60), 6.67% (4/60), 8.33% (5/60), 0 (0/60), 1.67% (1/60), 35.00% (21/60) in the control group, without statistically significant differences (χ²=0.000,P=1.000;χ²=0.000,P=1.000;χ²=0.000,P=1.000;χ²=0.134,P=0.714;χ²=0.109,P=0.741;P=1.000;χ²=0.000,P=1.000;χ²=0.320,P=0.572). After 1 year of following-up, the mortality rate of the control group was 8.33% (5/60), and the mortality rate of the experimental group was 5.00% (3/60), and there was no significant difference between the two groups (χ²=0.134,P=0.714).ConclusionBerberine hydrochloride combined with epirubicin and cisplatin is effective in treatment of advanced EC, which can decrease tumor marker levels, and it is safe and reliable of clinical reference.

Key words:Endometrial neoplasms,Berberine hydrochloride,Tumor markers

黄于庭, 汪超. 盐酸小檗碱联合表柔比星、顺铂对晚期子宫内膜癌的抗肿瘤效果[J]. 国际肿瘤学杂志, 2020, 47(9): 530-534.

Huang Yuting, Wang Chao. Anti-tumor effect of berberine hydrochloride combined with epirubicin and cisplatin on advanced endometrial carcinoma[J]. Journal of International Oncology, 2020, 47(9): 530-534.

图/表4

表1

两组晚期子宫内膜癌患者一般资料比较[$\bar{x}\pm s$/例(%)]"

一般资料	试验组(n=60)	对照组(n=60)	t/χ²/Z值	P值
年龄(岁)	55.38±6.10	55.02±6.84	0.304	0.761
BMI(kg/m²)	21.52±2.31	20.85±2.28	1.599	0.112
绝经	44(73.33)	45(75.00)	0.043	0.835
合并高血压	16(26.67)	18(30.00)	0.164	0.685
合并冠心病	11(18.33)	12(20.00)	0.054	0.817
合并糖尿病	5(8.33)	6(10.00)	0.100	0.752
临床分期
Ⅲ期	40(66.67)	39(65.00)	0.037	0.847
Ⅳ期	20(33.33)	21(35.00)
组织学分级
G1	9(15.00)	10(16.67)
G2	25(41.67)	24(40.00)	0.097	0.923
G3	26(43.33)	26(43.33)

表1

组别	CR	PR	SD	PD	总有效
试验组(n=60)	2(3.33)	36(60.00)	15(25.00)	7(11.67)	38(63.33)
对照组(n=60)	1(1.67)	26(43.33)	21(35.00)	12(20.00)	27(45.00)
Z/χ²值	4.489	4.062
P值	0.042	0.044

表2

组别	CA125(U/ml)			CEA(ng/ml)
试验组(n=60)	65.21±8.71	30.01±6.05^a	80.83±10.69	40.38±7.61^a	26.83±5.41	16.85±3.08^a
对照组(n=60)	65.93±7.52	45.83±6.91^a	81.10±10.25	48.89±8.05^a	26.47±4.99	20.20±4.18^a
t值	0.485	13.343	0.141	5.951	0.379	4.998
P值	0.629	<0.001	0.888	<0.001	0.705	<0.001

表3

组别	肝功能异常	肾功能异常	白细胞减少	血小板减少	恶心/呕吐	腹泻	口腔黏膜炎
试验组(n=60)	5(8.33)	3(5.00)	4(6.67)	4(6.67)	5(8.33)	1(1.67)	2(3.33)
对照组(n=60)	4(6.67)	2(3.33)	5(8.33)	4(6.67)	5(8.33)	0(0)	1(1.67)
χ²值	0.000	0.000	0.000	0.134	0.109	-	0.000
P值	1.000	1.000	1.000	0.714	0.741	1.000	1.000

表4

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