XELOX新辅助化疗用于局部进展期低位直肠癌的效果及对癌基因表达的影响  

Effect of XELOX neoadjuvant chemotherapy on locally advanced low rectal cancer and its effect on oncogene expression

作　　者：啜东宇[1] 林大鹏 陈玉泽[1] 刘放[1] CHUAI Dongyu;LIN Dapeng;CHEN Yuze;LIU Fang(Department of Colorectal Surgery,Liaoning Cancer Hospital,Shenyang 110042,China)

机构地区：[1]辽宁省肿瘤医院结直肠外科,110042

出　　处：《疑难病杂志》2019年第5期486-488,497,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：辽宁省自然科学基金指导计划立项项目(2017054)

摘　　要：目的研究XELOX新辅助化疗用于局部进展期低位直肠癌的效果,评估其对癌基因表达的影响。方法选择2014年2月—2016年9月在辽宁省肿瘤医院结直肠外科接受根治性手术治疗的局部进展期低位直肠癌患者88例,参照随机数字表法分为对照组(直接接受直肠癌根治术)、研究组(接受3个周期XELOX新辅助化疗+直肠癌根治术),每组44例。比较2组患者的病灶切除情况、外周血肿瘤标志物含量、病灶癌基因表达量、术后生存率的差异,记录XELOX新辅助化疗相关不良反应发生情况。结果研究组患者的病灶R0、R1切除率分别为95.45%和4.55%,显著优于对照组的79.55%和20.45%,差异有统计学意义(U/P=8. 074/0. 000);术后1周外周血中CA19-9的含量低于对照组(t/P=11.362/0. 000);病灶组织中PTTG、Smad4 mRNA的相对表达量高于对照组,Runx3、APC mRNA的相对表达量低于对照组(t/P=21. 673/0. 000、23. 550/0. 000、14. 200/0. 000、23. 930/0. 000); 2年总生存率(OS)水平高于对照组(χ~2/P=5.906/0.015);研究组患者化疗期间未出现严重不良反应。结论XELOX新辅助化疗用于局部进展期低位直肠癌,可提高手术效果并降低肿瘤恶性程度,改善患者生存率,且无明显不良反应。Objective To study the effect of XELOX neoadjuvant chemotherapy on locally advanced low rectal cancer and evaluate its effect on oncogene expression. Methods Eighty-eight patients with locally advanced low rectal cancer who underwent radical surgery in colorectal surgery of Liaoning Cancer Hospital from February 2014 to September 2016 were divided into control group(receiving radical resection of rectal cancer directly) and research group(receiving three cycles of XELOX neoadjuvant chemotherapy + radical resection of rectal cancer), 44 cases in each group. The differences of resection,peripheral blood tumor markers, oncogene expression and survival rate between the two groups were compared, and the incidence of adverse reactions related to neoadjuvant chemotherapy of XELOX was recorded. Results The resection rates of RO and R1 in the study group were 95. 45% and 4.55% respectively, which were significantly higher than those in the control group(79. 55% and 20.45%, respectively). The difference was statistically significant( U/P = 8. 074/0. 000);the level of CA19-9 in peripheral blood was lower than that in the control group(t/P = 11.362/0. 000);the relative expressions of PTTG and Smad4 in the lesions were higher than those in the control group, and the relative expressions of Runx3 and APC were lower than those in the control group. Group A(t/P = 21. 673/0. 000, t/P = 23. 550/0. 000, t/P = 14. 200/0. 000, t/P =23. 930/0. 000), 2-year overall survival rate( OS) was higher than that of the control group(χ^2/P =5. 906/0. 015). No serious adverse reactions occurred during chemotherapy in the study group. Conclusion XELOX neoadjuvant chemotherapy for locally advanced low rectal cancer can improve the surgical effect, reduce the malignancy of tumors, improve the survival rate of patients without obvious adverse reactions.

关 键 词：低位直肠癌 进展期 局部 XELOX新辅助化疗 癌基因 

分 类 号：R735.37[医药卫生—肿瘤]