健脾为主的中药干预对KRAS突变型Ⅱ~Ⅲ期结直肠癌患者预后的影响  

Effect of traditional Chinese medical treatment mainly for tonifying spleen on the prognosis of patients with stageⅡ-Ⅲcolorectal cancer of KRAS mutant

作　　者：汤紫怡 孟丹[1] 仇奕文 朱莹杰[1] TANG Ziyi;MENG Dan;QIU Yiwen;ZHU Yingjie(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《现代中西医结合杂志》2024年第13期1782-1787,1793,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市中医肿瘤临床医学研究中心建设项目(21MC1930500);上海市临床重点专科建设项目(中医肿瘤)(shslczdzk03701)。

摘　　要：目的观察以健脾为主的中药治疗对KRAS突变型Ⅱ~Ⅲ期结直肠癌患者预后的影响。方法采用回顾性非随机同期对照研究方法,收集2015年1月-2021年12月就诊于上海中医药大学附属龙华医院、复旦大学肿瘤医院闵行分院的116例KRAS突变型Ⅱ~Ⅲ期结直肠癌患者资料,以持续接受中药治疗≥3个月的患者为治疗组,以未接受中药规范治疗或持续时间<3个月的患者为对照组。比较2组患者的中位无病生存期(采用Kaplan-Meier法计算)及1,2,3,5年无病生存率,分析影响患者无病生存期的危险因素。结果治疗组中位无病生存期为23.13个月,较对照组的16.90个月明显延长(P<0.05);治疗组1,2,3,5年无病生存率分别为83%,46%,40%,30%,对照组分别为67%,38%,18%,6%,治疗组无病生存率明显高于对照组(P<0.05)。中药治疗为患者无病生存期的独立保护因素(P<0.05),脉管内癌栓是患者复发转移的独立危险因素(P<0.05),淋巴结分期为N1期的患者相比于N2期患者复发转移的风险更低(P<0.05)。结论健脾为主的中药治疗可有效延长KRAS突变型Ⅱ~Ⅲ期结直肠癌患者的无病生存期,降低复发转移率;脉管内癌栓及区域淋巴结是KRAS突变型Ⅱ~Ⅲ期结直肠癌患者复发转移的高危因素。Objective It is to observe the effect of traditional Chinese medical treatment mainly for tonifying spleen on the prognosis of patients with stageⅡ-Ⅲcolorectal cancer of KRAS mutant.Methods A retrospective non-randomized contemporaneous controlled study was conducted to collect data of 116 patients with stageⅡ-Ⅲcolorectal cancer of KRAS mutant treated in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine and Minhang Branch of Cancer Hospital of Fudan University from January 2015 to December 2021,and those who had continuously treated with traditional Chinese medicine for≥3 months were regarded as the treatment group,and those who had not received standardized traditional Chinese medicine treatment or the duration was<3 months were regarded as the control group.The median disease-free survival(calculated by the Kaplan-Meier method)and the 1-,2-,3-,and 5-year disease-free survival rates of the patients were compared between the two groups,and the risk factors affecting the disease-free survival of the patients were analyzed.Results The median disease-free survival of the treatment group was 23.13 months,which was significantly longer than that 16.90 months of the control group(P<0.05);the 1-,2-,3-,and 5-year disease-free survival rates of the treatment group were 83%,46%,40%,and 30%,respectively,those of the control group were 67%,38%,18%,and 6%respectively,and the disease-free survival rates of the treatment group were significantly higher than those of the control group(all P<0.05).Traditional Chinese medicine treatment was an independent protective factor for the disease-free survival(P<0.05),and intravascular cancer thrombus was an independent risk factor for the recurrent metastasis of the patients(P<0.05),and the patients with lymph node stage N1 had a lower risk of recurrent metastasis compared with the patients with stage N2(P<0.05).Conclusion Traditional Chinese medical treatment mainly for tonifying spleen can effectively prolong the disease-free survival and redu

关 键 词：健脾中药 KRAS突变 结直肠癌 无病生存期 

分 类 号：R735.35[医药卫生—肿瘤]