Effect of Combination Use of Qige San and Immunologic Therapy on Inflammatory Microenvironments, Skeletal Muscle Consumption and Circulating Tumor Cells After Esophagectomy
Abstract: Objective: To observe the effect of the combination use of Qige San and immunologic therapy on inflammatory microenvironments,skeletal muscle consumption and circulating tumor cells after esophagectomy. Methods: A total of 102 patients with esophageal cancer were selected, and 14 cases were culled. Finally in total 88 cases completed all courses of treatment and had complete records, and they were divided into the treatment group and the routine group according to the random number table method,with 44 cases in each group. The routine group was given radical resection of esophageal cancer and chemotherapy, and the treatment group was additionally treated with Qige San combined with immunologic therapy based on the treatment of the routine group. The clinical effects and disease control rate, and the changes of traditional Chinese medicine syndrome scores, high mobility group box-1 protein (HMGB1), interleukin-6 (IL-6), interferon- γ (IFN- γ), hypersensitive C-reactive protein (hs- CRP),circulating tumor cell (CTC),squamous cell carcinoma antigen (SCC-Ag),carcinoembryonic antigen (CEA), LMP2 mRNA, TAP and skeletal muscle index (SMI) before and after treatment, the incidence of adverse reactions and recurrence rates within two years were respectively compared between the two groups. Results:The disease control rate in the treatment group was higher than that in the routine group, the difference being significant (P<0.05). There was no significant difference being found in the comparison of total effective rate between the two groups (P>0.05). After treatment,the traditional Chinese medicine syndrome scores of choking when swallowing, excessive excretion of phlegm and drool, and abdominal distention and fullness in the two groups were reduced when compared with those before treatment (P< 0.05),and the above scores in the treatment group were lower than those in the routine group (P<0.05). Seven days after surgery, the levels of HMGB1, IL-6, IFN- γ and hs-CRP in both groups were upregulated when compared with those before treatment (P<0.05), and the above four levels in the treatment group were lower than those in the routine group (P<0.05). Seven days after surgery,the CCT content in both groups was elevated when compared with that before treatment (P<0.05), and the CCT content in the treatment group was lower than that in the routine group (P<0.05). After surgery,the levels of SCC-Ag, CEA and TAP in both groups were down-regulated when compared with those before treatment (P<0.05), and the LMP2 mRNA levels were increased when compared with those before treatment (P<0.05);the levels of SCC-Ag,CEA and TAP in the treatment group were lower than those in the routine group (P<0.05),and the LMP2 mRNA level was higher than that in the routine group (P<0.05). After surgery,the SMI in the two groups was decreased when compared with that before treatment (P< 0.05), and the SMI in the treatment group was higher than that in the routine group (P<0.05). The incidence of adverse reactions and recurrence rate in the treatment group were lower than those in the routine group. There was significance being found in the comparison of recurrence rate between the two groups (P<0.05). Conclusion: The combination use of Qige San and immunologic therapy has a great curative effect on patients after receiving surgery of esophageal cancer, which can enhance the postoperative inflammatory microenvironments,reduce skeletal muscle consumption and circulating tumor cells,improve the condition and the disease control rate,and reduce the recurrence rate with great safety.