香菇多糖注射液联合重组人血管内皮抑制素治疗伴腹腔转移胃癌的临床效果  

Clinical efficacy of lentinan injection combined with recombinant human endostatin in treatment of gastric cancer patients with abdominal cavity metastasis

作　　者：陈国栋 沈预程 Chen Guodong;Shen Yucheng(Department of Oncology,People's Hospital of Haian City in Jiangsu Province,Haian 226601,China)

机构地区：[1]江苏省海安市人民医院肿瘤科,226601

出　　处：《肿瘤研究与临床》2021年第5期359-363,共5页Cancer Research and Clinic

摘　　要：目的探讨香菇多糖注射液联合重组人血管内皮抑制素在伴腹腔转移胃癌患者治疗中的临床效果。方法选择2017年1月至2019年12月在江苏省海安市人民医院治疗的伴腹腔转移胃癌患者80例,根据随机数字表法分为对照组与观察组,每组40例。对照组给予FOLFOX(奥沙利铂+亚叶酸钙+5-氟尿嘧啶)方案化疗联合重组人血管内皮抑制素进行治疗,观察组在对照组基础上联合香菇多糖注射液进行治疗。观察两组患者治疗后近期疗效、治疗前后肿瘤标志物、免疫功能、血管新生相关因子水平以及不良反应。结果治疗后,观察组近期有效率为67.5%(27/40),高于对照组的47.5%(19/40)(χ^(2)=4.256,P<0.05);治疗后两组肿瘤特异性生长因子(TSGF)、癌胚抗原(CEA)、糖类抗原72-4(CA72-4)水平均较治疗前下降,且治疗后观察组TSGF、CEA、CA72-4水平均低于对照组[(48.99±3.14)U/ml比(55.17±3.68)U/ml,t=-8.080,P<0.01;(0.40±0.09)ng/ml比(0.47±0.10)ng/ml,t=-3.291,P=0.002;(3.51±1.14)U/ml比(8.42±2.57)U/ml,t=-11.045,P<0.01]。治疗后两组CD3+细胞比例、CD4+细胞比例及CD4+/CD8+比值均较治疗前下降,且治疗后观察组CD3+细胞比例、CD4+细胞比例及CD4+/CD8+比值均高于对照组[(38.53±5.12)%比(31.82±4.75)%,t=6.076,P<0.01;(25.36±4.39)%比(19.12±3.91)%,t=6.713,P<0.01;1.05±0.24比0.83±0.19,t=4.546,P<0.01]。治疗后两组血管新生相关因子p53、血管内皮生长因子(VEGF)、转化生长因子β1(TGF-β1)均较治疗前下降,且治疗后观察组p53、VEGF、TGF-β1水平均低于对照组[(132.86±31.24)ng/L比(163.24±33.27)ng/L,t=-4.210,P<0.01;(425.23±36.79)ng/L比(673.57±63.28)ng/L,t=-21.458,P<0.01;(35.87±4.03)ng/ml比(38.26±4.32)ng/ml,t=-2.559,P=0.012]。观察组Ⅲ-Ⅳ级不良反应发生率低于对照组[47.5%(19/40)比62.5%(25/40),χ^(2)=6.142,P<0.05]。结论香菇多糖注射液联合重组人血管内皮抑制素治疗伴腹腔转移胃癌患者效果较好,安全有效,值得临床推广。Objective To explore the clinical effect of lentinan injection combined with recombinant human endostatin in treatment of gastric cancer patients with abdominal cavity metastasis.Methods A total of 80 gastric cancer patients with abdominal cavity metastasis were treated in the People's Hospital of Haian City in Jiangsu Province from January 2017 to December 2019 were selected.They were randomly divided into the control group and the observation group according to the number table method,40 cases in each group.The control group was given FOLFOX(oxalipatin+calcium leucovorin+fluorouracil)chemotherapy combined with recombinant human endostatin,and the observation group was in combination of lentinan injection on the basis of the control group.The short-term efficacy,tumor markers before and after treatment,immune function,angiogenesis related factors levels and adverse reactions of the two groups were analyzed.Results After treatment,the short-term effective rate in the observation group was higher than that in the control group[67.5%(27/40)vs.47.5%(19/40),χ^(2)=4.256,P<0.05].The level of tumor markers like tumor supplied group of factors(TSGF),carcino-embryonic antigen(CEA),and carbohydrate antigen 72-4(CA72-4)of both groups after treatment was decreased compared with that before treatment;after treatment,the level of TSGF,CEA and CA72-4 in the observation group was lower than that in the control group[TSGF:(48.99±3.14)U/ml vs.(55.17±3.68)U/ml,t=-8.080,P<0.01;CEA:(0.40±0.09)ng/ml vs.(0.47±0.10)ng/ml,t=-3.291,P=0.002;CA72-4:(3.51±1.14)U/ml vs.(8.42±2.57)U/ml,t=-11.045,P<0.01].The proportion of CD3+,CD4+,and the ratio of CD4+/CD8+of both groups after treatment was decreased compared with that before treatment.The proportion of CD3+,CD4+,and the ratio of CD4+/CD8+in the observation group was higher than that in the control group after treatment[CD3+:(38.53±5.12)%vs.(31.82±4.75)%,t=6.076,P<0.01;CD4+:(25.36±4.39)%vs.(19.12±3.91)%,t=6.713,P<0.01;CD4+/CD8+:1.05±0.24 vs.0.83±0.19,t=4.546,P<0.01].The level of a

关 键 词：胃肿瘤 肿瘤转移 香菇多糖注射液 重组人血管内皮抑制素 免疫功能 

分 类 号：R735.2[医药卫生—肿瘤]