胃癌根治术联合腹腔植入氟尿嘧啶植入剂治疗Ⅲ期胃癌的疗效  

Curative effect of radical gastrectomy combined with intraperitoneal implantation of fluorouracil on stage Ⅲ gastric cancer

作　　者：李猛[1] 王道勤 董磊[1] 周蕾[2] LI Meng;WANG Dao-qin;DONG Lei;ZHOU Lei(Department of Gastrointestinal Surgery, Wanbei Coal-Electricity Group General Hospital, Suzhou, Anhui 234000, China)

机构地区：[1]皖北煤电集团总医院胃肠外科,安徽宿州234000 [2]蚌埠医学院第一附属医院病理科,安徽蚌埠233003

出　　处：《中国临床研究》2019年第7期950-953,共4页Chinese Journal of Clinical Research

基　　金：2016年度安徽省教育厅高校自然科学研究项目(KJ2016A488)~~

摘　　要：目的探讨胃癌根治术联合腹腔植入氟尿嘧啶植入剂(中人氟安)在Ⅲ期胃癌治疗中的临床应用及其疗效。方法选择2015年1月至2017年12月收治的80例Ⅲ期胃癌患者,采用随机数字表法均分为两组。观察组40例行胃癌根治术联合腹腔植入中人氟安,对照组40例单纯行胃癌根治术。对比两组术后存活率和转移率、并发症率、不良反应率及相关肿瘤指标。结果两组术后1年存活率差异无统计学意义(P>0.05),术后2年存活率观察组较对照组有所升高(65.00%vs 52.50%),转移率较对照组有所降低(17.50%vs 20.00%),但差异无统计学意义(P均>0.05);两组术后并发症总发生率和不良反应总发生率差异均无统计学意义(P>0.05);治疗前两组Ki-67阳性率、糖类抗原(CA)-199、癌胚抗原(CEA)水平相近(P均>0.05),治疗后,Ki-67阳性率、CA-199、CEA水平两组均较治疗前下降(P均<0.01),且CA-199、CEA水平观察组低于对照组(P均<0.01),但Ki-67阳性率两组间比较差异无统计学意义(P>0.05)。结论胃癌根治术联合腹腔植入中人氟安治疗Ⅲ期胃癌具有较好的安全性,与单纯胃癌根治术比较,能显著降低患者术后CA-199、CEA水平,有提高远期生存率、降低远期转移率的趋势,能否获得有统计学意义的改善,有待扩大样本量进一步研究。Objective To investigate the clinical application and efficacy of radical gastrectomy combined with intraperitoneal implantation of fluorouracil(Sinofuan) in the treatment of stage Ⅲ gastric cancer.Methods Eighty patients with stage Ⅲ gastric cancer admitted from January 2015 to December 2017 were randomly divided into two groups.Forty patients in the observation group underwent radical gastrectomy combined with intraperitoneal implantation of Sinofuan,while 40 patients in the control group underwent radical gastrectomy alone.After operation,the survival rate,metastasis rate,complication rate,adverse reaction rate and related tumor markers were compared between the two groups.Results No significant difference in 1-year survival rate between the two groups(P>0.05).The 2-year survival rate in the observation group was slightly higher than that in the control group,and the metastasis rate was slightly lower than that in the control group,but the difference was not statistically significant(all P>0.05).There was no significant difference in the total incidence of complications and adverse reactions between the two groups(all P>0.05).No significant difference was found in Ki-67 positive rate and levels of CA-199 and CEA between the two groups before treatment(all P>0.05).Compraed with before treatment, the positive rate of Ki-67 and the levels of CA-199 and CEA decreased in the two groups after treatment(all P<0.01),and the levels of CA-199 and CEA in the observation group were lower than those in the control group(all P<0.01),however, there was no significant difference in Ki-67 positive rate between the two groups(P>0.05).Conclusions Radical gastrectomy combined with intraperitoneal implantation of Sinofuan has good safety in the treatment of stage Ⅲ gastric cancer.Compared with the simple radical gastrectomy,it can significantly reduce the levels of CA-199 and CEA after operation,and has the tendency to improve the long-term survival rate and reduce the long-term metastasis rate.Whether it can achieve signifi

关 键 词：Ⅲ期胃癌 胃癌根治术 氟尿嘧啶植入剂 腹腔植入 

分 类 号：R735.2[医药卫生—肿瘤]