西咪替丁预防大肠癌复发转移临床疗效观察  

Cimetidine prevents recurrence and metastasis of colorectal cancer and its clinicl effects

作　　者：尚培中[1] 贾国洪[1] 苗建军[1] 崔丽[1] 李永庆[1] 李晓武[1] 朱习琴[1] 李霞[1] 谷化平[1] 

机构地区：[1]解放军第251医院普通外科,张家口075000

出　　处：《中华普通外科学文献（电子版）》2009年第1期27-30,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的研究西咪替丁预防大肠癌复发转移临床疗效以及与唾液酸化Lewis X(SLeX)蛋白表达的关系。方法应用微波-链霉菌素-生物素(微波-LSAB)法检测80例大肠癌SLeX蛋白表达水平。将阳性表达的73例随机分为两组:西咪替丁治疗组43例,对照组30例。手术后第3周开始,对Duke’sA期和B期患者,治疗组每天口服氟尿嘧啶200mg和西咪替丁800mg;对照组仅每天口服氟尿嘧啶200mg。对Duke’sC期患者,两组均采用LFP方案化疗,同时,分别采取上述方法对照治疗。服药时间均为1年。平均随访时间为(10.4±2.6)年。结果治疗组与对照组比较,10年总体生存率分别为83.7%和50.0%,Duke’sC期生存率分别为84.6%和22.2%,SLeX蛋白表达III级生存率分别为92.3%和29.4%,肝脏转移率分别为20.9%和53.3%,上述差异均有统计学意义(P<0.05);Duke’sA+B期生存率分别为82.4%和91.7%,SLeX蛋白表达II级生存率分别为70.6%和76.9%,局部复发率分别为25.6%和43.3%,上述差异均无统计学意义。结论西咪替丁对SLeX蛋白高水平表达的中晚期大肠癌有一定的抗转移治疗作用,有助于降低ΚΣ率,延长患者生存期,提高生存率。Objective To investigate the clinical effects of cimetidine for the treatment of colorectal cancer and the relationships with the expression of sialyl Lewis-X （SLeX） in colorectal carcinoma. Methods The expressions of SLeX in colorectal＇carcinoma （80 cases） were studied by microwave-labelled strept-avidin biotin immunohistochemical method. Seventy-three patients with positive expressions of SLeX were randomly allocated into two groups. The cimetidine group（43 cases） was given 200 mg per day of 5-fluorouracil orally together with 800 mg per day of cimetidine, while the control group（30 cases） received 5-fluorouracil alone. The treatment was initiated 3 weeks after the operation and terminated after one year for all patients. LFP chemotherapy was administrated for Duke＇s C patients. A mean follow-up term was （10.4 ± 2.6） years. Results The total 10-year survival rate in cimetidine group was 83.7%, whereas that in control group was 50.0%. The 10-year survival rate of Duke＇s C patients in cimetidine group was 84.6%, whereas that in control group was 22.2%. The 10-year survival rate of patients with high SLeX expression （grade Ⅲ） in cimetidine group was 92.3%, whereas that in control group was 29.4%. Hepatic metastasis in cimetidine group was 20.9%, whereas that in control group was 53.3%. The effects of cimetidine treatment as shown above parameters was remarkably significant （P〈0.05）. In contrast, the 10-year survival rate of Duke＇ s A＋B patients in cimetidine group was 82.4%, whereas that in control group was 91.7%. The 10-year survival rate of patients with low SLeX expression （grade Ⅱ ） in cimetidine group was 70.6%, whereas that in control group was 76.9%. Local recurrence in cimetidine group was 25.6%, whereas that in control group was 43.3%. The effects of cimetidine treatment as shown above parameters was not significant. Conclusion Cimetidine administration can dramatically improve patients＇ survival rate in advanced colorectal cancer patients with tumor cel

关 键 词：结直肠肿瘤 肿瘤转移 唾液酸化LEWIS X抗原 西咪替丁 

分 类 号：R735.34[医药卫生—肿瘤] R975.6[医药卫生—临床医学]