不同化疗方案联合腹腔镜远端胃癌D2根治术对进展期胃癌患者疗效及血清sEC、IGF、CEA水平的影响  

Effects of Different Chemotherapy Protocols Combined with Laparoscopic D2 Radical Resection for Distal Gastric Cancer on Curative Effect and Serum Levels of sEC,IGF and CEA in Patients with Advanced Gastric Cancer

作　　者：张敏康[1] 卜奎春 孟庆良[2] ZHANG Minkang;BU Kuichun;MENG Qingliang(Department of Gastroenterology,Xuzhou Central Hospital,Xuzhou,Jiangsu 221000,China;Department of Coloproctology,Xuzhou Central Hospital,Xuzhou,Jiangsu 221000,China;Department of General Surgery,Rehabilitation Hospital of Xuzhou City,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州市中心医院胃肠外科,江苏徐州221000 [2]徐州市中心医院肛肠科,江苏徐州221000 [3]徐州市康复医院普外科,江苏徐州221000

出　　处：《临床误诊误治》2024年第14期55-58,共4页Clinical Misdiagnosis & Mistherapy

基　　金：徐州市科技项目(KC22154)。

摘　　要：目的研究不同化疗方案联合腹腔镜远端胃癌D2根治术对进展期胃癌患者的疗效及血清可溶性E2钙粘连蛋白(sEC)、胰岛素样生长因子(IGF)、癌胚抗原(CEA)水平的影响。方法选择2020年3月至2023年6月收治的进展期胃癌患者150例,按照随机数字表法分成2组,其中对照组75例采用奥沙利铂和卡培他滨方案化疗联合腹腔镜远端胃癌D2根治术治疗,观察组75例采用多西他赛、奥沙利铂联合卡培他滨方案化疗(DOX方案)联合腹腔镜远端胃癌D2根治术治疗。观察比较2组围术期指标及化疗前后血清sEC、IGF、CEA水平和2组近期疗效、术后并发症发生情况。结果观察组术后肛门排气时间、术后第一次进食流质饮食时间和术后住院时间均短于对照组(P<0.05)。化疗后,sEC、IGF、CEA水平均下降,且观察组下降更显著(P<0.05,P<001)。观察组近期疗效显著高于对照组(P<0.05)。观察组术后并发症总发生率低于对照组(P<001)。结论DOX方案联合腹腔镜远端胃癌D2根治术治疗进展期胃癌效果较好,术后并发症发生率低,可以作为进展期胃癌患者的治疗备选方案。Objective To investigate the effect of different chemotherapy protocols combined with laparoscopic D2 radical resection for distal gastric cancer on curative effects and serum levels of soluble E2 calconnexin(sEC),insulin-like growth factor(IGF)and carcinoembryonic antigen(CEA)in patients with advanced gastric cancer.Methods A total of 150 patients with advanced gastric cancer admitted from March 2020 to June 2023 were selected and divided into two groups ac-cording to random number table method.Of them,75 patients in the control group were treated with XELOX protocol com-bined with laparoscopic D2 radical resection for distal gastric cancer,and 75 patients in the observation group were treated with DOX protocol combined with laparoscopic D2 radical resection for distal gastric cancer.Perioperative indexes,serum sEC,IGF and CEA levels before and after chemotherapy,short-term efficacy and postoperative complications of the two groups were observed and compared.Results The time of first postoperative anal exhaust,the first time of taking liquid diet postop-eratively and the length of postoperative hospitalization in the observation group were shorter than those in the control group(P<0.05).After chemotherapy,the levels of sEC,IGF and CEA were all decreased,and the decrease was more significant in observation group(P<0.05,P<0.01).The short-term curative effect of the observation group was significantly higher than that of the control group(P<0.05).The total incidence of postoperative complications in the observation group was low-er than that in the control group(P<0.01).Conclusion DOX protocol combined with laparoscopic D2 radical resection for distal gastric cancer is effective in the treatment of advanced gastric cancer,and the incidence of postoperative complications is low,which can be used as an alternative treatment for patients with advanced gastric cancer.

关 键 词：胃肿瘤 进展期 化疗 腹腔镜根治术 肛门排气时间 可溶性E2钙粘连蛋白 胰岛素样生长因子 

分 类 号：R735.2[医药卫生—肿瘤]