奥美拉唑联合FOLFOX方案应用于结肠癌根治术后辅助化疗的疗效研究  

The effect of omeprazole combined with FOLFOX scheme as an adjuvant therapy for stage II or III colon cancer patients after radical resection

作　　者：赵加应[1] 蔡元坤[1] 殷琛庆[1] 沈晨霞[1] 陈骏[1] 李小静[2] 舒维清[2] 

机构地区：[1]复旦大学附属上海市第五人民医院普外科,上海200240 [2]复旦大学附属上海市第五人民医院病理科,上海200240

出　　处：《中华普通外科杂志》2015年第8期650-653,共4页Chinese Journal of General Surgery

基　　金：上海市闵行区科委基金资助项目（2012MHZ021）

摘　　要：目的探讨质子泵抑制剂（PPI）奥美拉唑联合FOLFOX方案应用于Ⅱ、Ⅲ期结肠癌根治术后辅助化疗的疗效。方法研究2008--2009年上海市第五人民医院收治的Ⅱ、Ⅲ期结肠癌患者，将符合人组标准的98例患者随机分为研究组（48例）和对照组（50例），均先行结肠癌根治术，术后标本进行常规病理检测和免疫组化检测V—ATPase蛋白的表达情况。研究组应用奥美拉唑联合FOLFOX方案化疗。对照组应用FOLFOX方案化疗，化疗期限为6个月，行8～12个疗程，随访疗效。结果采用统计学分析。比较两组化疗不良反应和术后2、3和5年无病生存率（disease—free survival，DFS）的差异。结果93例完成研究，5例失访，两组患者基线资料分布基本平衡，研究组化疗的胃肠道反应不良反应低于对照组（χ^2=4．9246，P=0．026）。两组患者总体术后2、3和5年DFS分别为73％比60％（χ^2=1．7437，P=0．187）、62％比50％（χ^2=1．4075，P=0．235）、49％比40％（χ^2=0．8159，P=0．366），差异均无统计学意义（均P〉0．05）。结肠癌组织中V—ATPase蛋白阳性表达率为71％（70／98），V—ATPase蛋白阳性表达患者中研究组和对照组术后2、3年DFS分别为75％比51％（χ^2=3．9708，P=0．046）、66％比40％（χ^2=4．3995，P=0．036），与对照组相比，研究组术后2年和3年DFS提高，差异均有统计学意义（P〈0．05）；Ⅲ期结肠癌患者中研究组和对照组术后2年DFS分别为73％比47％（χ^2=4．5045，P=0．034），与对照组相比，研究组术后2年DFS提高，差异有统计学意义（P〈0．05）。结论PPI联合FOLFOX方案应用于V．ATPase蛋白阳性表达结肠癌患者或Ⅲ期结肠癌患者术后辅助化疗可改善疗效，降低化疗胃肠道不良反应。Objective To investigate the effect of omeprazole combined with FOLFOX scheme as an adjuvant therapy for stage II or IIIcolon cancer patients after a radical resection. Methods 98 stage II or III colon cancer patients in our hospital from January 2008 to December 2009 were randomly divided into study group （48 cases） receiving regimen of omeprazole combined with FOLFOX and control group （50 cases） treated with FOLFOX chemotherapy after radical colectomy. Surgical specimens were examined for expression of V-ATPase protein. Chemotherapy period was 6 months, 8 - 12 courses. We observed results of follow-up curative effect, comparing the side effects and postoperative 2 year, 3 year and 5 year disease-free survival rate （DFS） difference using statistical analysis. Results Study was completed in all 93 cases, 5 cases were lost to follow-up. The baseline data distribution in the two groups were balanced basically. In study group the gastrointestinal side effects of chemotherapy was lower than the control group （χ^2 = 4. 924 6,P = 0. 026）. In the two groups, the 2-year, 3-year and 5-year DFS were 73% vs 60% （χ^2 = 1. 743 7,P = 0. 187）, 62% vs 50% （χ^2 =1.407 5,P =0.235） ,49% vs 40% （χ^2 =0. 815 9,P =0. 366） （P 〉0.05）. V-ATPase protein expression was 71% （70/98） in all samples. The 2-year and 3-year DFS of patients for V-ATPase protein positive expression in the two groups were 75% vs 51% （χ^2 = 3. 970 8, P = 0. 046）, 66% vs 40% （χ^2 = 4. 399 5, P = 0. 036）. Compared with the control group, the 2-year, 3-year DFS increased in the study group （P 〈0. 05）. In stage III colon cancer patients, the 2-year DFS was 73% vs 47% （χ^2 = 4. 504 5,P = O. 034）. Conclusions PPI combined with FOLFOX in V-ATPase protein positive expression or III stage colon cancer patients after radical colectemy improves long-term survival, as well as reduces the gastrointestinal side effects of chemotherapy.

关 键 词：结肠肿瘤 抗肿瘤联合化疗方案 奥美拉唑 无病生存 

分 类 号：R735.35[医药卫生—肿瘤]