表柔比星、奥沙利铂、5-氟尿嘧啶化疗方案联合生物治疗应用于胃癌新辅助化疗的效果  

Study on the killing effect of epirubicin,oxaliplatin and 5-fluorouracil combined with biotherapy in neoadjuvant chemotherapy for gastric cancer

作　　者：郭元彪[1] 陈敬贤[1] 阮铭[1] 郑岚[1] GUO Yuanbiao;CHEN Jingxian;RUAN Ming;ZHENG Lan(Department of Traditional Chinese Medicine,Ruijin Hospital,School of Medicine of Shanghai Jiaotong University,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院中医科,上海200025

出　　处：《新疆医科大学学报》2021年第5期576-580,共5页Journal of Xinjiang Medical University

基　　金：国家中医药管理局国家中医临床研究基地科研项目(JDZX2015068)。

摘　　要：目的观察表柔比星+奥沙利铂+5-氟尿嘧啶化疗方案联合生物治疗用于胃癌新辅助化疗的癌细胞杀伤效果。方法选取在上海交通大学医学院附属瑞金医院接受术前新辅助化疗的胃癌患者100例,随机接受表柔比星+奥沙利铂+5-氟尿嘧啶化疗方案联合树突状细胞-细胞因子诱导的杀伤细胞(联合组)或表柔比星+奥沙利铂+5-氟尿嘧啶化疗方案(对照组),每组各50例,化疗前后测定血清肿瘤标志物的含量,化疗后测定手术切除病灶中增殖基因、抑癌基因的表达量并评估化疗有效率。结果化疗后,对照组及联合组患者血清中CA72-4、G17、TK-1的含量均低于化疗前[联合组:CA72-4(27.11±3.85)ng/mL vs(55.27±7.68)ng/mL,G17(46.13±8.79)ng/mL vs(78.84±9.65)ng/mL,TK-1(1.32±0.31)pmol/mL vs(3.18±0.47)pmol/mL;对照组:CA72-4(39.83±5.12)ng/mL vs(54.76±8.14)ng/mL,G17(56.71±8.76)ng/mL vs(78.65±9.48)ng/mL,TK-1(2.26±0.33)pmol/mL vs(3.38±0.42)pmol/mL],且联合组低于对照组[CA72-4(27.11±3.85)ng/mL vs(39.83±5.12)ng/mL,G17(46.13±8.79)ng/mL vs(56.71±8.76)ng/mL,TK-1(1.32±0.31)pmol/mL vs(2.26±0.33)pmol/mL],差异有统计学意义(P<0.05);联合组患者手术切除病灶中各增殖基因mRNA表达量低于对照组[CyclinB:(0.32±0.04)vs(0.96±0.12),CyclinD1:(0.28±0.04)vs(1.02±0.11),CDK1:(0.41±0.04)vs(1.06±0.13),CDK4(0.77±0.03)vs(1.02±0.18),CDK6(0.24±0.06)vs(0.98±0.12)],差异有统计学意义(P<0.05);联合组患者手术切除病灶中各抑癌基因mRNA表达量低于对照组[RASSF1A(0.36±0.08)vs(1.00±0.09),Noxa(0.44±0.09)vs(1.02±0.18),CKN1(0.28±0.10)vs(1.03±0.15),p16ink4a(0.62±0.09)vs(0.99±0.12)],差异有统计学意义(P<0.05);联合组手术切除率以及根治性切除率均高于对照组(根治性切除率52.00%vs 30.00%,手术切除率70.00%vs 42.00%),差异有统计学意义(P<0.05);联合组不良反应发生率与对照组相比差异无统计学意义(30.00%vs 32.00%)(P>0.05);联合组有效率高于对照组(60.00%vs 40.00%),差异有统�Objective To observe the killing effect of epirubicin+oxaliplatin+5-fluorouracil combined with biotherapy in neoadjuvant chemotherapy for gastric cancer.Methods One hundred patients with gastric cancer who received preoperative neoadjuvant chemotherapy in hospital were randomly treated with epirubicin+oxaliplatin+5-fluorouracil chemotherapy combined with dendritic cells-cytokine induced killer cells(combined group)and epirubicin+oxaliplatin+5-fluorouracil chemotherapy(control group).The content of serum tumor markers was measured before and after chemotherapy.The expression of proliferating gene and tumor suppressor gene and the effective rate of chemotherapy were measured after chemotherapy.Results After chemotherapy,the contents of CA72-4,G17 and TK-1 in serum of patients in control group and combined group were lower than those before chemotherapy(Combined group:CA72-427.11±3.85 vs 55.27±7.68,G1746.13±8.79 vs 78.84±9.65,TK-11.32±0.31 vs 3.18±0.47;Control group:CA72-439.83±5.12 vs 54.76±8.14,G1756.71±8.76 vs 78.65±9.48,TK-12.26±0.33 vs 3.38±0.42),and those in the combined group was lower than that in the control group(CA72-427.11±3.85 vs 39.83±5.12,G1746.13±8.79 vs 56.71±8.76,TK-11.32±0.31 vs 2.26±0.33),the difference was statistically significant.The mRNA expression of proliferating genes in the combined group was lower than that in the control group(CyclinB 0.32±0.04 vs 0.96±0.12,CyclinD10.28±0.04 vs 1.02±0.11,CDK10.41±0.04 vs 1.06±0.13,CDK40.77±0.03 vs 1.02±0.18,CDK60.24±0.06 vs 0.98±0.12).The expression of tumor suppressor genes mRNA in the combined group was lower than that in the control group(RASSF1A 0.36±0.08 vs 1.00±0.09,Noxa 0.44±0.09 vs 1.02±0.18,CKN10.28±0.10 vs 1.03±0.15,p16ink4a 0.62±0.09 vs 0.99±0.12),the difference was statistically significant(P<0.05).The surgical resection rate and radical resection rate in the combined group were significantly higher than those in the control group(radical resection rate 52.00%vs 30.00%,surgical resection rate 70.00%vs 42.0

关 键 词：胃癌 表柔比星 奥沙利铂 5-氟尿嘧啶 

分 类 号：R739.9[医药卫生—肿瘤]