胸腺五肽辅助治疗肺癌对免疫功能影响及其疗效的系统评价
Evaluation of Thymopentin in Adjuvant Therapy for Patients with Lung Cancer: a Meta-analysis of Randomized Trials
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摘要: 为了系统地评价胸腺五肽作为辅助药物治疗各种肺癌的疗效及其对机体免疫功能的影响, 利用电子检索收集有关胸腺五肽联合放疗或化疗方案治疗肺癌的临床随机对照试验文献, 对符合纳入标准的文献, 采用RevMan5.3 软件进行系统评价。最终共纳入文献 9 篇, 总样本量 784 例。Meta 分析结果表明, 胸腺五肽作为辅助药物治疗各种肺癌提高总有效率的差异无统计学意义OR = 1.44, 95%CI(0.99, 2.10), P =0.06 > 0.05。在对免疫功能的影响方面, 胸腺五肽的使用显著增高外周血中的 CD3+ 细胞水平OR = 5.88, 95% CI(2.34, 9.42), P =0.001, CD4+ 细胞水平也显著上升OR =8.32, 95%CI(5.22, 11.42), P < 0.00001 , CD4+ /CD8+比值也有明显的提高OR = 0.38, 95% CI(0.18, 0.59), P=0.0002, 但 CD8+ 细胞水平的差异无统计学意义OR =-3.12, 95% CI ( -9.02, 2.79), P >0.05。总的来说, 本研究在一定程度上反映了在辅助治疗肺癌方面, 胸腺五肽能显著提高外周血中的 CD3+ 细胞水平、CD4+ 细胞水平、CD4+/CD8+ 比值。而对于治疗的有效率、CD8+ 细胞水平, 差异无统计学意义。Abstract: To evaluate the effect of thymopentin (TP5) on immune function and curative effect in adjuvant therapy for patients with lung cancer, we searched online for randomized, placebo-controlled trials that using TP5 as an adjuvant therapy with chemotherapy or radiotherapy for patients with lung cancer, and then evaluated the trials that meet criteria with the software RevMan5.3. As a result, 9 trials were included and 784 patients were observed. The meta-analysis shows that there is no significant change between the experimental group and the control group in terms of the curative effect of lung cancer (OR=1.44, 95%CI(0.99, 2.10), P=0.06>0.05). As to the effect of immune function, TP5 altered the CD3+cell level (OR=5.88, 95% CI(2.34, 9.42), P=0.001, CD4+ cell level(OR=8.32, 95%CI(5.22, 11.42), P<0.00001), but did not alter the CD8+ cell level (OR=-3.12, 95% CI(-9.02, 2.79), P>0.05) which led to a significant change of the CD4+/CD8+ ratio(OR=0.38, 95% CI(0.18, 0.59), P=0.0002). To sum up, TP5 altered the CD3+ cell level, CD4+ cell level and CD4+/CD8+ ratio but did not alter the CD3+ cell level and curative effect.