结直肠癌术前区域动脉灌注化疗联合腹腔镜手术对患者血清EGFR HER-2 MMP-2表达及远期预后的影响  

Effect of preoperative regional arterial infusion chemotherapy combined with laparoscopic surgery on serum EGFR HER-2 MMP-2 expression and long-term prognosis of colorectal cancer

作　　者：王进峰[1] 彭雷 付豹[1] 陈小贺[1] WANG Jinfeng;PENG Lei;FU Bao(Department of Surgery,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]石家庄市中医院外科,河北石家庄050000 [2]石家庄市藁城区人民医院外科,河北石家庄050000

出　　处：《安徽医学》2021年第12期1355-1359,共5页Anhui Medical Journal

基　　金：河北省医学科学研究重点课题计划(项目编号:20181087)。

摘　　要：目的探讨结直肠癌(CRC)术前区域动脉灌注化疗(PRAC)联合腹腔镜手术对患者表皮生长因子受体(EGFR)、人类表皮生长因子受体(HER-2)、基质金属蛋白酶-2(MMP-2)表达及远期预后的影响。方法选取2014年1月至2015年12月在石家庄市中医院就诊的CRC患者164例,依据随机数字表法分为对照组81例(腹腔镜手术治疗)与研究组83例(PRAC联合腹腔镜手术治疗)。观察两组手术情况,治疗前后均测定患者血清EGFR、HER-2、MMP-2表达水平,统计患者并发症发生情况,比较患者治疗后1、3年预后情况及治疗后3年复发、转移情况。结果研究组术中出血量少于对照组(t=8.895,P=0.000)。两组治疗前后血清EGFR、HER-2、MMP-2表达水平差值比较,差异有统计学意义(t=6.357、3.509、6.345,P均<0.05)。两组并发症总发生率比较,差异无统计学意义(χ^(2)=0.245,P=0.620)。研究组治疗后1年生存率(77/83,92.77%)显著高于对照组(61/81,75.31%),治疗后3年生存率(52/83,62.65%)显著高于对照组(29/81,35.80%),差异均有统计学意义(χ^(2)=9.371、14.039,P=0.002、0.000);随访中,研究组患者发生肝转移、肺转移、骨转移及局部复发共19例,对照组共31例,两组比较差异有统计学意义(χ^(2)=4.576,P=0.032)。结论PRAC联合腹腔镜手术能减少CRC患者术中出血量,降低血清EGFR、HER-2、MMP-2表达水平,远期生存率高且复发率少。Objective To investigate the effect of preoperative regional arterial infusion chemotherapy(PRAC)combined with laparoscopic surgery on the expression of serum EGFR,proto oncogene HER-2 and MMP-2 and long-term prognosis of CRC.Methods A total of 164 CRC patients admitted to Shijiazhuang Hospital of Traditional Chinese Medicine from January 2014 to December 2015 were randomly divided into control group(81 cases treated with laparoscopy surgery)and study group(83 cases treated with PRAC combined with laparoscopic surgery).The operation conditions of the two groups were observed,the expression levels of serum EGFR,HER-2,and MMP-2 were measured before and after treatment,the incidence of complications was counted,and the prognosis of 1 and 3 years after treatment,recurrence and metastasis 3 years after treatmentwere compared.Results The intraoperative blood loss of the study group was less than that of the control group(t=8.895,P=0.000).The difference in serum EGFR,HER-2,MMP-2 expression levels before and after treatment between the two groups was statistically significant(t=6.357,3.509,6.345,all P<0.05,0.001,0.000).There was no significant difference in the total incidence of complications between the two groups(χ^(2)=0.245,P=0.620).The 1-year survival rate of the study group(77/83,92.77%)was significantly higher than that of the control group(61/81,75.31%),the 3-year survival rate(52/83,62.65%)was significantly higher than that of the control group(29/81,35.80%),and the difference between the two groups was statistically significant(χ^(2)=9.371,14.039,P=0.002,0.000).During the follow-up,19 cases of liver metastasis,lung metastasis,bone metastasis and local recurrence occurred in the study group,and 31 cases in the control group,and the difference between the two groups was statistically significant(χ^(2)=4.576,P=0.032).Conclusions PRAC combined with laparoscopic surgery can reduce the intraoperative blood loss and the expression levels of serum EGFR,HER-2 and MMP-2 in patients with CRC,and it has high long-term s

关 键 词：术前区域动脉灌注化疗 腹腔镜手术 结直肠癌 表皮生长因子受体 原癌基因人类表皮生长因子受体2 基质金属蛋白酶2 

分 类 号：R735.34[医药卫生—肿瘤]