摘要
目的研究在晚期卵巢癌治疗中采用阿帕替尼联合新辅助化疗的可能作用机制。方法选取2018年4月至2020年4月张家口市第一医院确诊为晚期卵巢癌的患者90例,根据治疗方案的不同分为对照组(n=45)和研究组(n=45)。对照组采用紫杉醇+顺铂化疗方案,研究组在对照组基础上加用阿帕替尼治疗。化疗结束后,2组均进行肿瘤细胞减灭术。比较2组治疗前后肿瘤组织肿瘤微血管密度(MVD)、血管内皮生长因子(VEGF)阳性表达率、凋亡及PI3K/AKT/mTOR通路关键分子表达、外周血T淋巴细胞亚群及生活质量变化。结果治疗前,2组肿瘤组织MVD、VEGF、血管内皮生长因子受体2(VEGFR2)阳性表达率、Bax、Cleaved Caspase-3、Bcl-2、p-PI3K、p-AKT、p-mTOR蛋白表达、外周血CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)及社会状况、功能状况、生理状况、情感状况、附加关注评分比较,差异无统计学意义(P>0.05);治疗3个疗程后,2组肿瘤组织MVD、VEGF、VEGFR2阳性表达率、Bcl-2、p-PI3K、p-AKT、p-mTOR蛋白表达、外周血CD8^(+)及生理状况、情感状况、附加关注评分均较同组治疗前降低,肿瘤组织Bax、Cleaved Caspase-3蛋白表达、外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)及社会状况、功能状况评分均较同组治疗前升高(P<0.05),且研究组肿瘤组织MVD、VEGF、VEGFR2阳性表达率、Bcl-2、p-PI3K、p-AKT、p-mTOR蛋白表达、外周血CD8^(+)及生理状况、情感状况、附加关注评分低于对照组,肿瘤组织Bax、Cleaved Caspase-3蛋白表达、外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)及社会状况、功能状况评分高于对照组(P<0.05)。结论阿帕替尼联合新辅助化疗治疗晚期卵巢癌可调控PI3K/AKT/mTOR通路抑制肿瘤组织血管新生血管形成,诱导肿瘤细胞凋亡,并改善患者免疫功能和生活质量。
Objective To investigate the mechanism of apatinib combined with neoadjuvant chemotherapy in the treatment of advanced ovarian cancer.Methods A total of 90 patients with advanced ovarian cancer who were admitted in Zhangjiakou First Hospital from April 2018 to April 2020 were enrolled in the study.Patients were divided into the control group(n=45,taxol and cisplatin regimen)and study group(n=45,apatinib plus taxol and cisplatin regimen)according to the treatment regimen.After chemotherapy,a cytoreductive surgery was performed in both groups.Microvessel density(MVD),positive rate of vascular endothelial growth factor(VEGF),apoptosis,key protein levels in the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of the rapamycin(PI3K/Akt/mTOR)signaling pathway,T lymphocyte subsets in peripheral blood and quality of life before and after treatment in two groups were analyzed.Results There were no significant differences in the MVD,positive rates of VEGF and VEGF receptor 2(VEGFR2),protein expressions of Bax,Cleaved Caspase-3,Bcl-2,p-PI3K,p-AKT and p-mTOR in ovarian cancer tissues,peripheral CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+),and scores of social status,functional status,physiological status,emotional status,additional concern and other items before the treatment between the two groups(P>0.05).After three courses,MVD,positive rates of VEGF and VEGFR2,protein expressions of Bcl-2,p-PI3K,p-AKT and p-mTOR in ovarian cancer tissues,peripheral blood CD8^(+),and scores of physiological status,emotional status,additional concern and other items were significantly reduced,while the protein expressions of Bax and Cleaved Caspase-3 in ovarian cancer tissues,peripheral blood CD3^(+),CD4^(+),and CD4^(+)/CD8^(+),and scores of social status and functional status were significantly elevated in both groups(P<0.05),which were more pronounced in the study group than the control group(P<0.05).Conclusion Apatinib combined with neoadjuvant chemotherapy can effectively reduce the angiogenesis of tumor tissue,promote the apoptosis of ovarian cancer cells by suppressing the PI3K/Akt/mTOR signaling pathway,which improves the immune function and life quality of patients.
作者
李倩
田霞
谢心弦
李宁
段春梅
LI Qian;TANG Xia;XIE Xinxian(Department of Gynecology,Zhangjiakou First Hospital,Hebei,Zhangjiakou 075000,China)
出处
《河北医药》
2025年第6期939-942,共4页
Hebei Medical Journal
关键词
阿帕替尼
新辅助化疗
晚期卵巢癌
apatinib
neoadjuvant chemotherapy
advanced ovarian cancer
