低剂量地西他滨对铂类不敏感型卵巢上皮性癌糖链抗原125水平的影响及临床价值  

Effect of low dose decitabine on CA125 of platinum-insensitive epithelial ovarian cancer

作　　者：靖爽 罗穗豫 井佳雨 刘慧丽 王悦 JING Shuang;LUO Suiyu;JING Jiayu;LIU Huili;WANG Yue(Department of Gynecology and Obstetrics,People′s Hospital ofZhengzhou University,Henan Provincal People′s Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院妇科河南省人民医院妇科

出　　处：《实用医学杂志》2019年第11期1828-1831,共4页The Journal of Practical Medicine

基　　金：河南省科技攻关项目(编号:162102310174)

摘　　要：目的探讨低剂量地西他滨(DAC)联合紫杉醇和卡铂(PC方案)对铂类不敏感型卵巢上皮性癌的糖链抗原125(CA125)水平的影响和临床价值。方法卵巢上皮性癌手术石蜡标本行化疗药物的切除修复交叉互补基因(ERCC1)表达水平检测,筛选铂类不敏感型卵巢上皮性癌41例,观察组21例给予低剂量DAC联合PC化疗方案,对照组20例给予PC化疗方案。每1周期进行一次疗效评定和不良反应监测,若出现无法耐受的不良反应则停止化疗,化疗6个周期。结果低剂量DAC联合PC方案组的疾病控制率为71.4%,高于PC方案组的疾病控制率40%,差异有统计学意义(χ^2=4.11,P=0.043);两组的总有效率分别是47.6%、25%,差异无统计学意义(χ^2=2.26,P=0.132)。低剂量DAC联合PC方案组的患者出现粒细胞减少的发生率(66.7%)高于PC方案组(58.1%),差异有统计学意义(χ^2=33.48,P <0.01),但以Ⅰ~Ⅱ度为主,经升白治疗后恢复正常,未延误下一周期化疗。恶心呕吐(χ^2=0.21,P=0.650)、肝功能损伤(χ^2=0.035,P=0.851)、胃肠道不良反应(χ^2=0.60,P=0.438)等,两组发生率无明显差异。低剂量DAC联合PC方案组的患者,化疗1周期后CA125水平的降低幅度与PC方案组相比,差异无统计学意义,但是化疗6周期后的血清中CA125水平的降低幅度大于PC方案组的患者,差异有统计学意义(P <0.05)。结论低剂量DAC可以增强卵巢上皮性癌对铂类化疗药的敏感性,足够疗程的低剂量DAC联合PC方案显著降低铂类不敏感型卵巢上皮性癌CA125水平,临床效果好,不良反应可耐受。Objective To evaluate the CA125 level and the clinical value of low dose Decitabine in the treatment of Platinum-insensitive epithelial ovarian cancer. Methods The level of ERCC1 was detected in Paraffin specimens,forty-one cases of Platinum-insensitive epithelial ovarian cancer were enrolled in this study. Patients in the experimental group received intravenous injection of Decitabine combined with taxol and carboplatin. Patients in the control group received taxol and carboplatin chemotherapy. The clinical value and chemotherapy drugs adverse reactions were evaluated every one cycle treatment. The chemotherapy was suspended when the drugs adverse reactions were intolerable to patients. Results The disease control rate was 71.4% in the low dose Decitabine combined with taxol and carboplatin group,which was 40% in the taxol and carboplatin group(χ^2= 4.11,P =0.043),with no significant difference in the total effective rate between the two groups(χ^2= 2.26,P= 0.132). The incidences of granulocytopenia in the group DAC was 66.7%,higher than that(58.3%)in the group PC(χ^2= 33.48,P < 0.01). However,most of granulocytopenia in group DAC was stage I and II,and all patients had received systemic chemotherapy punctually. No significant differences were found in nausea and vomiting(χ^2= 0.21,P = 0.650),liver dysfunction(χ^2= 0.035,P = 0.851)and gastrointestinal reaction(χ^2=0.60,P=0.438)between the two groups.The level of CA125 in group DAC was lower than that in group PC,when the patients had received the first and the sixth chemotherapy(P < 0.05). Conclusion Low dose Decitabine can enhance the sensitivity of epithelial ovarian cancer to Platinum. Low dose Decitabine combined with taxol and carboplatin can reduce CA125 level,with mild drugs adverse reactions.

关 键 词：地西他滨 卵巢上皮性癌 化疗 

分 类 号：R737.31[医药卫生—肿瘤]