OXA方案治疗老年原发性肝癌晚期患者的疗效及对血清中D-二聚体和CyclinD蛋白的影响  

Efficacy of OXA Regimen in the Treatment of Elderly Patients with Advanced Primary Liver Cancer and its Effect on Serum D-dimer and CyclinD Protein

作　　者：刘换 王凤稳 骆淑萍 梁荔 LIU Huan;WANG Feng-wen;LUO Shu-ping;et al(Department of Hepatobiliary Surgery,Shandong Provincial Third Hospital,Jinan Shandong 250031)

机构地区：[1]山东省立第三医院肝胆外科,山东济南250031

出　　处：《医学临床研究》2022年第7期1037-1039,1043,共4页Journal of Clinical Research

摘　　要：【目的】探讨奥沙利铂(OXA)方案治疗老年原发性肝癌晚期患者的疗效及对血清中D-二聚体和细胞周期蛋白D(CyclinD)的影响。【方法】本院收治的26例老年原发性肝癌晚期患者为观察组,以本院同期健康体检者120例为对照组。比较OXA方案治疗观察组1、2、3个疗程后的疗效及两组对象血清中D-二聚体、纤维蛋白原、纤维蛋白原降解产物(FDP)、CyclinD及热休克蛋白70(HSP70)的表达水平,并统计化疗期间不良反应情况及远期疗效。【结果】治疗后,随着疗程的增加,患者完全缓解和部分缓解的比例明显升高,且各疗程比较,差异均有统计学意义(P<0.05)。治疗前,观察组各项指标均明显高于对照组,且差异有统计学意义(P<0.05)。治疗后,肝癌晚期患者血清中D-二聚体、纤维蛋白原、FDP、CyclinD、HSP70的表达水平较治疗前明显降低(P<0.05),且随着治疗时间的延长,各指标水平呈逐渐降低趋势(P<0.05)。患者化疗过程中出现恶心、呕吐1例,血液学毒性1例,周围神经毒性1例,总不良反应率为11.54%(3/26)。随访1年,有4例患者出现复发或转移,中位无进展生存期为7个月。【结论】OXA方案治疗对老年原发性肝癌晚期患者有明显的效果,其作用可能与患者血清中D-二聚体、CyclinD蛋白的表达有关。【Objective】To investigate the efficacy of oxaliplatin(OXA)regimen in the treatment of elderly patients with advanced primary liver cancer and its effect on serum D-dimer and CyclinD protein.【Methods】A total of 26 patients with advanced primary liver cancer were treated in our hospital as the observation group,and 120 healthy persons in the same period as the control group.The efficacy of oxa regimen after 1,2 and 3 courses of treatment and the expression levels of D-dimer,fibrinogen,fibrinogen degradation products(FDP),CyclinD and heat shock protein 70(HSP70)in the serum of the two groups were compared,and the adverse reactions and long-term efficacy of chemotherapy were counted.【Results】After treatment,with the increase of the course of treatment,the proportion of complete remission and partial remission increased significantly,and there was significant difference in each course of treatment(P<0.05).Before treatment,the indexes of the observation group were significantly higher than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the expression levels of D-dimer,fibrinogen,FDP,CyclinD and HSP70 in serum of patients with advanced liver cancer were significantly lower than those before treatment(P<0.05),and with the extension of treatment time,the levels of various indicators showed a gradual downward trend(P<0.05).One patient had nausea and vomiting,one had hematological toxicity and one had peripheral neurotoxicity during chemotherapy.The total adverse reaction rate was 11.54%(3/26).After 1 year follow-up,4 patients had recurrence or metastasis,and the median progression free survival was 7 months.【Conclusion】OXA regimen has obvious effect on elderly patients with advanced primary liver cancer,which may be related to the expression of D-dimer and CyclinD protein in serum.

关 键 词：肝肿瘤 有机铂化合物/药理学 纤维蛋白纤维蛋白原降解物 老年人 治疗结果 

分 类 号：R735.7[医药卫生—肿瘤]