Study Of The Cell-mediated Immunity Of Hormone Independent Prostate Cancer And The Intervention Of Fuzhengyiliu Therapy

Prostate cancer is one of the most common urology tumor,in recent years, the incidence of prostate cancer is rising continuously in China,and now it has become the third common tumors of Urogenital.Endocrine therapy for prostate cancer is currently the main treatment,but now studies have shown that after amedian survival time of 14 to 30 months,most patients eventually are transformed to hormone independent prostate cancer.Therefore,it is an urgent problem need to be resolved that how to find effective treatment for hormone independent prostate cancer to enhancing quality of life of the patients and prolonging their survival time.Traitional Chinese Medicine(TCM) is an effective way to prevent and cure cancer,one of the important anti-tumor mechanisms is found that to regulate the immune function of patients,so that to reconstruct the immune balance function of patients or enhance the immune function.According to TCM theory,hormone independent prostate cancer is an extreme deficient disease,so my tutor professor Chen Zhiqiang proposes the theory of Fuzheng aiming to Yiliu,point to treating patients by tonifying deficient symptoms,and it had gained fine effects in clinical.This study is to investigate the relevance between hormone independent prostate cancer and cell-mediated immunity,and to observe the clinical efficacy and possible mechanism of Fuzhengyiliu therapy for hormone independent prostatecancer,therefore to provide clinical basis for the effective treatment of hormone-dependent of prostate combining TCM with western medicine.ObjectiveTo investigate the changes of cell-mediated immunity of hormone independent prostate cancer,evaluate the clinical efficacy of patients treated by Fuzhengyiliu therapy and its impact on the level of cell-mediated immunity. Methods36 cases of patients with hormone independent prostate cancer were selected to be studyed,and 39 cases with prostate cancer in hormone dependent period were selected as control study group,T lymphocyte subsets(CD₃⁺,CD₄⁺,CD₈⁺) and Nature Killer cell(CD_(16+56)^-+) activities in peripheral blood of all patients were detected by Flow cytometry(FCM).At the same time,36 cases of patients with hormone independent prostate cancer were divided into two groups(treatment group and control group)according to different treatment methods in the light of cohort study method.The control group was treated by the current second-line endocrine therapy,and the treatment group was treated by the second-line hormonal therapy and Fuzheng yiliu therapy.Before and after treatment,the changes of clinical symptoms,peripheral serum prostate specific antigen(pSA) and the changes of local lesions of all patients were detected,and also all were gived a mark of the Karnofsky Scale score:After treating for three months,the treatment group and control group were decected the level of peripheral blood CD₃⁺,CD₄⁺,CD₈⁺ and CD_(16+56)⁺ again.ResultsAs compared with the control study group(the patients with hormone dependent period prostate cancer),the level of CD₃⁺T,CD₄⁺T and CD₈⁺T were significantly decreased before treating in hormone independent prostate cancer patients,and the difference was statistically significant(P＜0.05). And the level of CD_(16+56)⁺N of hormone independent prostate cancer also decreased significantly when compared with the control study group.However,the ratio of CD₈⁺/CD₈⁺ increased,the difference was not statistically significant compared with the control study group.After the treatment,The effective rate of the Fuzhengyiliu therapy group was 78.94%,and the control group was 56.25%in clinical symptoms,In controlling of PSA levels,there were 14 cases who had been found decreased more than 50%in Fuzhengyiliu therapy group,and 2 cases continued to rise; And there were 7 cases decreased by more than 50%in control group;That is to say,the effective rate of Fuzhengyiliu therapy group was 73.68%and the control group was 43.75%in pSA levels,and there was significant difference in statistics between Fuzhengyiliu therapy group and control group according to Ridit analysis method(P<0.05).Furthermore,on quality of life scored by the Karnofsky Scale score method,it also has significant statistical difference between the pro-treatment and the pre-treatment of the Fuzhengyiliu therapy group(P<0.01).After the treatment,the Karnofsky score of the control group slightly increased,however,there was no statistic difference when comparing patients after treatment with pre-treatment patients.In the cell-mediated immunity,the CD₃⁺ and CD₈⁺ level in Fuzhengyiliu therapy group showed significant statistic differences when after treatment patients compared with before treatment(P<0.05),but no significant difference was found in the control group of those index.The CD₈⁺ level in the Fuzhengyiliu therapy group decreased slightly after the treatment,while increased slightly in the control group after the treatment,however,there was no statistic difference in both of them.The ratio of CD₄⁺/CD₈⁺ T in the Fuzhengyiliu therapy group increased distinctly after the treatment(P<0.05),but those in the control group had no obvious difference. The level of CD_(16+56)⁺ in the Fuzhengyiliu therapy group had increased significantly after treatment(P<0.05),while that in the control group decreased,and there was no obvious difference comparing patients before treatment with those after treatment.ConclusionThe level of CD₃⁺,CD₄⁺,CD₈⁺ and CD_(16+56)⁺ were decreased overall in hormone independent prostate cancer patients;Fuzhengyiliu therapy could improve the clinical symptoms effectively,control the level of pSA,and evidently improve the quality of life of the patients;After treated by Fuzhengyiliu therapy,the level of CD₃⁺,CD₄⁺ and CD_(16+56)⁺ were significantly raised.It is suggested that there is a dysfunction condition mainly suppressed or significantly decreased in cell-mediated immunity function of patients with hormone independent prostate cancer;Fuzheng Yiliu therapy could treat the patients effectively, probably by adjusting the level of cell-mediated immunity of the patients.