塞来昔布联合奥曲肽抑制人胃癌生长的临床研究  

The clinical randomized trials of celecoxib in combination with octreotide on the growth of human gastric cancer

作　　者：黄茂涛[1] 陈志新[2] 魏兵[3] 张波[2] 王春晖[4] 黄明慧[4] 唐承薇[1] 

机构地区：[1]四川大学华西医院消化内科,成都610041 [2]四川大学华西医院胃肠外科,成都610041 [3]四川大学华西医院病理科,成都610041 [4]国家教育部人类疾病生物治疗重点实验室人类疾病相关多肽研究室

出　　处：《中华消化杂志》2005年第9期534-538,共5页Chinese Journal of Digestion

基　　金：国家自然科学基金项目(30170418)

摘　　要：目的探讨环氧合酶-2(COX-2)抑制剂塞来昔布联合生长抑素类似物奥曲肽在人体内对胃癌生长的抑制作用。方法51例胃癌患者随机分为对照组15例,术前不用药物;塞来昔布组18例,术前口服塞来昔布0.2g,每天1次,共7d;联合组18例,术前口服塞来昔布0.2g+奥曲肽100μg皮下注射,每天1次,共7d。术中切除标本送组织学研究,分析胃癌组织坏死、炎性细胞浸润及纤维组织增生情况。免疫组化法检测胃癌组织微血管密度(MVD)及胃癌细胞COX-2表达情况,DNA末端原位标记染色法检测胃癌细胞凋亡。实时荧光定量逆转录聚合酶链反应法检测术前内镜活检的胃癌组织生长抑素受体(SSTR)的mRNA表达量。结果与对照组比较,联合组胃癌组织坏死差异有统计学意义(P<0.05),纤维组织增生明显(P<0.05),胃癌细胞凋亡率(7.06%)高于对照组(6.23%),差异有统计学意义(P<0.05)。联合组肿瘤组织中的MVD(20.44)较对照组(24.87)明显减少(P<0.05),而各组COX-2表达差异无统计学意义(P>0.05)。所有胃癌组织均有SSTR-1,SSTR-2,SSTR-3的mRNA表达。结论塞来昔布联合奥曲肽对人体内胃癌生长具有明显抑制作用。Objective To investigate the inhibitory effect of cyclooxygenase-2 （COX-2） inhibitor celecoxib alone and in combination with somatostatin （SST） analog octreotide on human gastric cancer. Methods Fifty one gastric cancer patients were randomly divided into 3 groups. The patients in control group（n= 15）took no medicine before gastric cancer resection. Celecoxib group（n= 18）patients took celecoxib orally 0.2 g/d for 7 days before surgery. Combination group（n= 18） patients tookcelecoxib orally 0.2 g/d and were injected octreotide 100μg/d subcutaneously for 7 days before surgery. The resected specimens were examined histologically, including status of tumor necrosis, inflammatory cells infiltration and fibrous tissue proliferation. The microvessel density （MVD） and the expression of COX-2 in gastric cancer were evaluated by immunohistochemical methods. The apoptosis of tumor cells was measured by terminal deoxynucleotidyl transferse-mediated-dUTP nick end labeling. The expression of somatostatin receptor （SSTR） -1 ,SSTR-2 and SSTR-3 mRNA in gastric cancer tissue obtained by biopsy in all patients were detected by using real time fluorescence quantitative RT-PCR. Results Compared with control group, gastric cancer tissue necrosis increased significantly（P〈0.05）and fibrous tissue proliferation degree increased significantly in combination group （P〈0.05）. The apoptosis rate in combination group （7.06%） increased significantly compared with that in control group （6.23%） （P〈0.05）. The MVD （20. 44） decreased significantly in combination group compared with that in control group （24.87） （P〈0.05）. COX-2 expression showed no significant difference in each group. The SSTR-1, SSTR-2 and SSTR-3 mRNA were all expressed in gastric cancer. Conclusions Celecoxib combined with octreotide can inhibit the growth of human gastric cancer.

关 键 词：胃肿瘤 塞来昔布 奥曲肽 

分 类 号：R735.2[医药卫生—肿瘤] R971.1[医药卫生—临床医学]