晚期胃癌患者行紫杉醇联合卡培他滨化疗效果及血清内皮抑素、VEGF变化研究  

Chemotherapy effect of paclitaxel combined with capecitabine in patients with advanced gastric cancer and changes of serum endostatin and VEGF

作　　者：江承川 刘莎[1] 赵惠萍 李湘军 杨洲[1] 唐三元 JIANG Chengchuan;LIU Sha;ZHAO Huiping;LI Xiangjun;YANG Zhou;TANG Sanyuan(Department of Oncology,the Second People's Hospital/Hunan Brain Hospital,Changsha,Hunan 410007,China)

机构地区：[1]湖南省第二人民医院/湖南省脑科医院肿瘤科,湖南长沙410007

出　　处：《国际检验医学杂志》2019年第10期1192-1196,共5页International Journal of Laboratory Medicine

基　　金：长沙市科技局科研资金资助项目(k1403066-31)

摘　　要：目的分析晚期胃癌患者应用紫杉醇联合卡培他滨化疗方案的疗效及血清内皮抑素、血管内皮生长因子(VEGF)变化。方法选择2014年4月至2016年4月该院收治的胃癌晚期患者90例作为研究对象,采用随机数字表法分为对照组和研究组,每组45例。在常规治疗基础上对照组采用顺铂联合卡培他滨化疗方案,研究组采用紫杉醇联合卡培他滨化疗方案;对两组患者近期临床效果,血清肿瘤标记物——癌胚抗原(CEA)、癌抗原72-4(CA72-4)、糖链抗原19-9(CA19-9)及内皮抑素、VEGF水平变化情况,不良反应,随访1年生存情况等进行比较。结果研究组患者总有效率[40.0%(18/45)]明显高于对照组[22.2%(10/45)],差异有统计学意义(χ~2=4.558,P=0.033);疾病控制率[73.3%(33/45)]明显高于对照组[51.1%(23/45)],差异有统计学意义(χ~2=4.727,P=0.030);研究组患者治疗后CEA、CA72-4、CA19-9、VEGF水平均明显低于对照组,内皮抑素水平明显高于对照组,差异均有统计学意义(t=9.608、13.781、4.668、7.623、5.331,P=0.000);两组患者化疗期间口腔炎、恶心及呕吐、白细胞减少、血红蛋白降低、血小板减少、腹泻、手足综合征、水钠潴留、周围神经毒性、脱发等不良反应发生率比较,差异均无统计学意义(χ~2=0.505、0.518、0.916、0.442、0.121、0.145、0.100、0.471、0.104、0.412,P=0.478、0.472、0.338、0.506、0.728、0.703、0.752、0.492、0.747、0.521);研究组患者1年生存率[51.1%(23/45)]与对照组[40.0%(18/45)]比较,差异无统计学意义(χ~2=2.272,P=0.132)。结论晚期胃癌患者行紫杉醇联合卡培他滨化疗临床有效,可显著降低血清肿瘤标记物、VEGF水平,提高内皮抑素水平。Objective To analyze the chemotherapy effect of paclitaxel combined with capecitabine in patients with advanced gastric cancer and changes of serum endostatin and VEGF.Methods A total of 90 patients with advanced gastric cancer,who were treated in hospital from April 2014 to April 2016,were selected and divided into the control group and study group by random number table,45 cases in each group.On the basis of conventional treatment,the control group were added with cisplatin combined with capecitabine chemotherapy,while the study group were added with paclitaxel combined with capecitabine chemotherapy.To compare the recent clinical effects,adverse events,survival of 1-year follow-up and changes of serum tumor markers like CEA,CA72-4,CA19-9,endostatin,VEGF levels in the two groups.Results The total effective rate and disease control rate of the study group [40.0%(18/45),73.3%(33/45)] were higher than those of the control group [22.2%(10/45),51.1%(23/45)] with statistically significant difference (χ^2=4.558,4.727;P=0.033,0.030).After treatment,the levels of CEA,CA72-4,CA19-9 and VEGF in the study group were significantly lower than those in the control group,but the level of indostatin was prominently higher than that in the control group,with statistically significant difference ( t =9.608,13.781,4.668,7.623,5.331;P=0.000).The difference on adverse reactions like stomatitis,nausea and vomiting,leukopenia,hemoglobin reduction,thrombocytopenia,diarrhea,hand and foot syndrome,sodium and water retention,peripheral nerve toxicity and hair loss during chemotherapy in both groups had no statistical significance (χ^2=0.505,0.518,0.916,0.442,0.121,0.145,0.100,0.471,0.104,0.412;P=0.478,0.472,0.338,0.506,0.728,0.703,0.752,0.492,0.747,0.521 ).The difference on 1-year survival rate between the study group [51.1%(23/45)] and the control group [40.0%(18/45)] was statistically significant difference (χ^2=2.272;P=0.132).Conclusion Paclitaxel combined with capecitabine chemotherapy is effective in patients with advanced gastric

关 键 词：胃肿瘤 内皮抑素类 内皮生长因子 紫杉酚 卡培他滨 

分 类 号：R735.2[医药卫生—肿瘤] R446.61[医药卫生—临床医学]