替吉奥联合奥沙利铂对晚期胃癌患者生存周期及血清甲胎蛋白、糖类抗原242的作用  

Effect of tegafur combined with oxaliplatin on the life cycle and serum alpha-fetoprotein and carbohydrate antigen 242 levels in patients with advanced gastric cancer

作　　者：杨金珠[1] 宋琪 沈磊 Yang Jinzhu;Song Qi;Shen Lei(Department of Oncology,Hefei Third People′s Hospital,Hefei 230022,China)

机构地区：[1]合肥市第三人民医院肿瘤科,230022

出　　处：《中国医师进修杂志》2021年第6期509-515,共7页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨替吉奥联合奥沙利铂对晚期胃癌患者生存周期及血清甲胎蛋白(AFP)、糖类抗原242(CA242)的作用。方法选取2016年10月至2019年10月合肥市第三人民医院收治的100例晚期胃癌患者,按随机数字表法分为两组,各50例。对照组采用亚叶酸钙+氟尿嘧啶+奥沙利铂治疗,观察组采用替吉奥联合奥沙利铂治疗。比较两组缓解率、疾病控制率、中位无进展生存期(PFS)、中位总生存期(OS)、不良反应发生情况;比较两组治疗前后血清肿瘤标志物AFP、CA242、癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)水平;比较两组治疗前后促肿瘤生长指标血管内皮生长因子(VEGF)、基质金属蛋白酶(MMP)-2、MMP-9、胰岛素样生长因子-1(IGF-1)、血小板内皮细胞黏附分子-1(PECAM-1)水平;比较两组治疗前后微小RNA(miR)216a、miR95、miR4286水平。结果观察组缓解率为42.0%(21/50),高于对照组的22.0%(11/50),差异有统计学意义(P<0.05)。观察组治疗后AFP、CA242、CEA、CA125、CA19-9均低于对照组[(15.04±3.65)μg/L比(20.65±4.17)μg/L、(20.88±6.37)kU/L比(35.46±7.33)kU/L、(8.65±2.13)μg/L比(15.39±3.25)μg/L、(26.15±8.49)kU/L比(34.16±7.50)kU/L、(22.29±5.80)kU/L比(38.81±6.79)kU/L],差异均有统计学意义(P<0.05)。观察组治疗后VEGF、MMP-2、MMP-9、IGF-1、PECAM-1低于对照组;观察组治疗后miR216a高于对照组,miR95、miR4286低于对照组,差异均有统计学意义(P<0.05)。对照组中位PFS为3.0个月,中位OS为6.6个月,观察组中位PFS为3.3个月,中位OS为7.0个月,差异均无统计学意义(P>0.05)。观察组骨髓抑制、皮肤损害发生率低于对照组[6.0%(3/50)比24.0%(12/50)、4.0%(2/50)比18.0%(9/50)],差异有统计学意义(P<0.05)。结论替吉奥联合奥沙利铂治疗晚期胃癌,能提高抗癌效果,促进病情缓解,安全性高,其机制可能与抑制促肿瘤生长指标、调控miR有关。Objective To investigate the effect of tegafur combined with oxaliplatin on the life cycle and serum alpha-fetoprotein(AFP)and carbohydrate antigen 242(CA242)levels in patients with advanced gastric cancer.Methods A total of 100 patients with advanced gastric cancer admitted to Hefei Third People′s Hospital from October 2016 to October 2019 were selected and divided into two groups according to randomization,with 50 cases in each group.The patients in the control group received calcium leucovorin and fluorouracil and oxaliplatin,and the patients in the observation group was treated with tegafur combined with oxaliplatin.The remission rate,disease control rate,median progression-free survival(PFS),median overall survival(OS),side effects and serum tumor markers AFP,CA242,carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9),tumor growth promoting indicators vascular endothelial growth factor(VEGF),matrix metalloproteinase(MMP)-2,MMP-9,insulin-like growth factor-1(IGF-1),platelet endothelial cell adhesion molecule-1(PECAM-1),microRNA(miR)216a,miR95,miR4286 before and after treatment of the two groups were compared.Results The remission rate in the observation group was higher than that in the control group:42.0%(21/50)vs.22.0%(11/50),and the difference was statistically significant(P<0.05).After treatment,the levels of AFP,CA242,CEA,CA125,CA19-9 in the observation group were lower than those in the control group:(15.04±3.65)μg/L vs.(20.65±4.17)μg/L,(20.88±6.37)kU/L vs.(35.46±7.33)kU/L,(8.65±2.13)μg/L vs.(15.39±3.25)μg/L,(26.15±8.49)kU/L vs.(34.16±7.50)kU/L,(22.29±5.80)kU/L vs.(38.81±6.79)kU/L,and the differences were statistically significant(P<0.05).The levels of VEGF,MMP-2,MMP-9,IGF-1 and PECAM-1 in the observation group were lower than those in the control group;the level of miR216a in the observation group was higher than that in the control group,and the levels of miR95 and miR4286 were lower than those in the control group,and the differences were stat

关 键 词：胃肿瘤 甲胎蛋白类 抗原 肿瘤相关 碳水化合物 替吉奥 奥沙利铂 生存周期 

分 类 号：R735.2[医药卫生—肿瘤]