伊立替康辅助常规化疗对术后转移性胃癌患者的疗效分析  

Effects of irinotecan adjuvant conventional chemotherapy on serum tumor markers,FAS and Neuropilin-1 levels in patients with postoperative metastatic gastric cancer

作　　者：许伦[1] 李英[2] 尤玮[1] XU Lun;LI Ying;YOU Wei(Department of Oncology,Zigong Fourth People′s Hospital,Zigong 643000,China;Department of Ultrasoung,Zigong Fourth People′s Hospital,Zigong 643000,China)

机构地区：[1]四川省自贡市第四人民医院肿瘤科,643000 [2]四川省自贡市第四人民医院超声科,643000

出　　处：《现代消化及介入诊疗》2021年第7期833-838,共6页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：四川省科技计划项目(2018JDR1279)。

摘　　要：目的探讨伊立替康辅助常规化疗在术后转移性胃癌患者中的应用效果,为延长患者生存时间提供参考。方法选取2016年10月至2019年1月自贡市第四人民医院术后转移性胃癌患者86例,依据随机数字表法分为研究组与对照组,各43例。对照组采取FOLFOX4常规化疗(奥沙利铂联合5-氟尿嘧啶及亚叶酸钙),研究组在对照组基础上加用伊立替康。统计两组疗效、治疗前后血清肿瘤标志物[糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、细胞角蛋白18(CK18)、再生基因蛋白Ⅳ(REGⅣ)]水平、血清脂肪酸合酶(FAS)、神经纤毛蛋白-1(Neuropilin-1)含量、生存质量(EORTC QLQ-C30)评分及毒副反应发生情况,并比较两组治疗后12个月生存曲线。结果连续治疗2个周期后两组总有效率差异无统计学意义(P>0.05)。研究组和对照组治疗后12个月累积生存率和中位生存时间分别为41.86%、32.56%和9.6个月、7.3个月,生存曲线比较,差异有统计学意义(P<0.05)。治疗后两组血清CA19-9、CEA、CK18、REGⅣ水平较治疗前均明显降低,且研究组低于对照组(P<0.05)。治疗后两组血清FAS、Neuropilin-1含量较治疗前降低,且研究组低于对照组(P<0.05)。治疗后研究组躯体功能、情绪功能、总体健康、社会功能评分均高于对照组(P<0.05)。两组骨髓抑制、血小板减少、中性粒细胞减少、呕吐恶心、胃肠道反应发生率比较差异均无统计学意义(P>0.05)。结论伊立替康辅助常规化疗在术后转移性胃癌患者中的应用效果良好,可有效下调肿瘤标志物表达,降低血清FAS、Neuropilin-1含量,延长患者生存周期,且不增加毒副反应风险,对患者生命安全的维护具有积极作用。Objective To investigate the effect of irinotecan adjuvant convenional chemotherapy in patients with postoperative metastatic gastric cancer,and to provide reference for treatment options for prolonging the survival time of patients.Methods A total of 86 patients with postoperative metastatic gastric cancer in our hospital from October 2016 to January 2019 were selected and divided into a study group and a control group,with 43 cases in each group,according to the random number table method.The control group received FOLFOX4 conventional chemotherapy(oxaliplatin combined with 5-fluorouradil and leucovorin),and the study group received irinotecan on the basis of the control group.The tumor control rates and serum tumor markers[carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA),cytokeratin 18(CK18),regenerative gene proteinⅣ(REGⅣ)]levels,serum fatty acid synthase(FAS),neuropilin-1(Neuropilin-1)content,quality of life(EORTC QLQ-C30)score before and after treatment and occurrence of toxic and side effects in the two groups were counted.The survival cycles[median progression-free survval(PFS),median overall survival(OS)]of the two groups were followed up and statistics.Results(1)Tumor control and survival:There was no significant difference in tumor control rate between the two groups(P>0.05).The follow-up results showed that the median PFS and median OS of the study group were higher than those of the control group(P<0.05);(2)Tumor markers:Compared with before treatment,the serum leves of CA19-9,CEA,CK18 and REGⅣin the two groups were significantly reduced after treatment,and the study group was lower than the control group(P<0.05);(3)FAS and Neuropilin-1 content After treatment,the serum FAS and Neuropilin-1 content in the two groups were lower than before treatment,and the reduction in the study group was higher(P<0.05);(4)Quality of life:EORTC QLQ-C30 scale evaluation results showed that the physical function,emotional function,overall health,and social function scores of the study group were hi

关 键 词：术后转移性胃癌 伊立替康 FOLFOX4化疗 肿瘤控制 肿瘤标志物 脂肪酸合酶 神经纤毛蛋白-1 生存周期 

分 类 号：R735.2[医药卫生—肿瘤] R573[医药卫生—临床医学]