Expression Of Transcription Factors And Cytokines Of Th1/Th2 In Radiotherapy Patients With Esophageal Squamous Cell Carcinoma And The Regulative Study Of Aidi Injection

Objective1 To investigate the relation between expression of transcription factors and cytokines of Th1/Th2 type and clinicopathologic factors in peripheral blood of patients with esophageal squamous cell carcinoma(ESCC).2 To study on the expression of transcription factors and cytokines of Th1/Th2 type influenced by radiotherapy in peripheral blood of patients with ESCC and the regulative study of Aidi injection on it,to provide evidence for using traditional Chinese medicine in anti-tumor immunotherapy.Methods1 Research methods1.1 To detect the expression of transcription factors and cytokines of Th1 and Th2 type in 60 patients with ESCC.To abstract total RNA,the gene expression of T-bet and GATA-3 in peripheral blood monoclear cell(PBMC) were detected by real-time fluorescence quantitative polymerase chain reaction(RT-FQ-PCR),and the expression of interferonγ(IFN-γ), interleukin 2,4 and 10(IL-2,IL-4,IL-10) in blood plasma were detected by Enzyme-linked immunosorbent assay(ELISA).A group consisted of 20 healthy persons was set meanwhile for normal control.1.2 To observe relation between the radio of T-bet/GATA-3 and Th1/Th2 shift in patients with ESCC. 1.3 A total of 60 patients were allocated into different groups according to the tumor's degree of differentiation,pathological type,lesion location, lesion extent and CT staging,to investigate the relation between Th1/Th2 shift and clinical clinicopathologic factors.1.4 A total of 60 radiotherapy patients with ESCC were randomly assigned equally into the single radiotherapy group(three-dimensional conformal radiotherapy.3D-CRT) and Aidi group(Aidi injection applied by intravenous drip during radiotherapy).Patient's expression of transcription factors and cytokines of Th1 and Th2 type were detected before and after radiotherapy.1.5 According to Wanjun's evaluation criterion to evaluate the recent cure rate after radiotherapy,and according to RTOG criterion to evaluate incidence of radiation esophagitis and leukopenia2 Treatment methodsAll patients underwent simulation CT scans before 3D-CRT.Patients in Aidi group were treated with 50 mL Aidi injection,once a day during radiotherapy.3 Statistical analysisSPSS 11.0 statistical software was applied to analyze the data.Results of two samples were compared using two-sample t-test,mean before and after radiotherapy using paired t-test,multi-group using one-factor ANOVA, enumeration data using chi-square test,P＜0.05 represents statistical significance.Results1 Compared with healthy controls,the expression of Th1 type transcription factor T-bet and cytokines IFN-γ,IL-2 in ESCC patients were significantly lower(P＜0.01),while expression of Th2 type transcription factor GATA-3 and cytokines IL-4,IL-10 were significantly higher(P＜0.01).2 The radio of T-bet/GATA-3 in patients with ESCC was significantly lower than in the control group(P＜0.01),and the expression level of IFN-γand IL-2 had positive correlation with the radio of T-bet/GATA-3,while IL-4 and IL-10 had negative correlation with it.3 Analyzed the expression of transcription factors and cytokines of Th1/Th2 type between Th1/Th2 shift and clinical pathological agents in patients with ESCC:As the tumor's degree of differentiation progressed,the levels of T-bet,IFN-γand IL-2 were lower whereas the levels of GATA-3,IL-4 and IL-10 were higher,but there were not statistically significance between them(P＞0.05);There were not statistically significance between medullary,fungating,ulcerating and intraluminal type,but compared with the early esophageal cancer,they had statistically significance(P＜0.05); there were not statistically significance between the different lesion location groups;Compared with the stage ofⅠ+Ⅱ,the levels of T-bet,IFN-γand IL-2 were lower whereas the levels of GATA-3,IL-4 and IL-10 were higher in the stage ofⅢ+Ⅳ(P＜0.05);As the tumor's lesion extent enlarged,the levels of T-bet,IFN-γand IL-2 were lower whereas the levels of GATA-3,IL-4 and IL-10 were higher,there were statistically significance between them(P＜0.05).4 Compared with before radiotherapy,the expression of T-bet and IFN-γ, IL-2 were significantly lower(P＜0.01),GATA-3,IL-4 and IL-10 were significantly higher(P＜0.01) in the single radiotherapy group,while in the Aidi group,T-bet,IFN-γand IL-2 were slightly lower(P＞0.05),GATA-3, IL-4 and IL-10 were slightly higher(P＞0.05).There were statistically significance between the margin of transcription factors and cytokines of Th1/Th2 type in two groups before and after radiotherapy(P＜0.05).5 The recent cure rate has no statistically significant between the two groups(P＞0.05),but compared with the single radiotherapy group,total incidence and severity of radiation esophagitis and leukopenia were significantly depressed in the Aidi group(P＜0.05).Conclusion1 Th1/Th2 shift was existed in the patients with ESCC,and there were significant correlation with the tumor's CT staging and lesion extent,but there was not significantly relation to the lesion location,pathological type and degree of differentiation.2 The radio of T-bet/GATA-3 in patients with ESCC could represent the imbalance of Th1/Th2. 3 Radiotherapy can not reverse the imbalance of Th1/Th2.Although the combined intravenous dripping of Aidi injection during radiotherapy can not improve the recent cure rate,it can inhibit the Th1/Th2 shift,elevate the immune function in organism,and decrease the toxic-adverse effect of radiotherapy.