自体干细胞结合高剂量动脉化疗晚期胃癌作用研究  

Autologous peripheral blood stem cell combined with high-dose arterial chemotherapy for advanced gastric cancer

作　　者：朱金水[1] 朱励[1] 王龙[1] 庄奇新[1] 胡兵[1] 达炜[1] 陈维雄[1] 陈国强 马积庆[3] 

机构地区：[1]上海交通大学附属第六人民医院消化科,上海市200233 [2]国家南方基因中心血液分子研究室,上海市200025 [3]复旦大学附属肿瘤医院,上海市200031

出　　处：《世界华人消化杂志》2002年第12期1408-1411,共4页World Chinese Journal of Digestology

基　　金：上海市第六人民医院重点项目;六院科字;No.ZDI2000-4~~

摘　　要：目的:本文采用自体外周造血干细胞联合高剂量超选择胃左动脉化疗晚期胃癌患者,探讨其近期疗效及对机体免疫调节因子影响.方法:所有晚期胃癌患者采用数字化血管造影(DSA)引导下超选择高剂量动脉EAP方案化疗后,均接受自体外周血干细胞移植.结果:自体外周血干细胞移植结合高剂量EAP动脉化疗治疗组对晚期胃癌有效率为85.0%,治疗前肿瘤体积为40.5±3.4cm3,1疗程后16.7±1.4cm3;而全身静脉EAP化疗晚期胃癌有效率为35.0%,治疗前肿瘤体积为39.4±3.2cm3,1疗程后30.2±2.6cm3;动脉化疗后再输注自体外周造血干细胞胃癌患者,其机体白介素-2,γ-干扰素,可溶性白介素-2受体则显著下降.结论:自体外周造血干细胞联合高剂量EAP动脉化疗方案是治疗不能手术晚期胃癌新方法,同时还可提高机体中央免疫调节因子IL-2,γ-干扰素水平,降低免疫抑制因子sIL-2R功能.AIM:To evaluate immune modulator of high dose EAP(etopside + etopmycine + carplatine) arterial chemo-therapy combined with autologous peripheral blood stemcell transplantation (APBSCT) in the treatment of patientswith late gastric cancer.METHODS:All patients accepted arterial chemotherapy or/and combined with autologous peripheral blood stem celltransplantation.RESULTS:Effective rate of EAP arterial chemotherapy combinedwith APBSCT was up to 85. 0 % (17/20), compared withcontrol group (35.0 %, 7/20) in late stage of gastric cancer.APBSCT enhanced obviously the proliferation of peripheralblood cells and expression of serum interleukin-2 receptorand interferon-gamma levels in the patients. Mean volumesof gastric cancer were 40.5±3.4 cm3 and 39.4±3.2 cm3respectively before chemotherapy, and 16.7±1.4 cm3 and30.2±2.6 cm3 after treatment using different regiment 4weeks. The difference between the groups was significant.Interleukin-2, interferon-gamma, serum interleukin-2 receptorwere 21.72 ±2.3 ku·L-1, 632.9±47.8 ku·L-1,768.3±67.2 ku·L-1 and 79.3±7.4 ku·L-1,2356.5±121.3 ku·L-1,and 234.8 ±12.9 ku·L-1respectively before chemotherapy. After 4 weeks EAP arterialchemotherapy combined with APBSCT, the two groups weresignificantly different (P <0.01).CONCLUSION:EAP arterial chemotherapy combined withAPBSCT was a new effective scheme for the treatment oflate gastric cancer with malignant ascites; APBSCT mayrestore patient’s immune and hematopoietic reconstruction,and it can decrease side-effects of high-dosage arterialchemotherapy,and improved the patient’s immune modulatorfunction.

关 键 词：自体干细胞 高剂量动脉化疗 晚期胃癌 疗效 免疫调节因子 

分 类 号：R735.2[医药卫生—肿瘤] R730.[医药卫生—临床医学]