联合应用二甲双胍、紫杉醇化疗对2型糖尿病合并食管癌患者临床疗效、血糖水平、肿瘤标志物的影响  

Metformin combined with paclitaxel chemotherapy for patients with type 2 diabetes mellitus and esophageal cancer:Clinical efficacy and impact on blood glucose levels and tumor markers

作　　者：施文文 柯海姑 陈淑卿[1] 盛敏慧 Wen-Wen Shi;Hai-Gu Ke;Shu-Qing Chen;Min-Hui Sheng(Department of Pharmacy,Hangzhou Cancer Hospital,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]杭州市肿瘤医院药学部,浙江省杭州市310000

出　　处：《世界华人消化杂志》2025年第2期114-121,共8页World Chinese Journal of Digestology

摘　　要：背景二甲双胍是2型糖尿病(type 2 diabetes mellitus,T2DM)的一线药物,紫杉醇是食管癌常用化疗药物,对于T2DM合并食管癌患者,在抗肿瘤的同时还需关注血糖的控制情况,二甲双胍、紫杉醇化疗联合应用可能提升T2DM合并食管癌患者的治疗效果.目的探究二甲双胍和紫杉醇化疗联合在2型糖尿病(type2 diabetes mellitus,T2DM)合并食管癌患者中的应用效果,并分析对血糖水平、肿瘤标志物的影响.方法选取2018-10/2022-10我院收治的200例T2DM合并食管癌患者,根据治疗方案分为研究组、对照组,各100例,均给予基础控糖、放化疗,对照组给予紫杉醇化疗,研究组联合应用二甲双胍和紫杉醇化疗,比较两组疗效、糖代谢水平[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 hours postprandial blood glucose,2 h PBG)、糖化血红蛋白(glycosylated hemoglobin A1c,HbAlc)]、肿瘤标志物水平[糖链抗原724(carbohydrate antigen 724,CA724)、细胞角蛋白19片段(cytokeratin-19-fragment,CYFRA21-1)、鳞状细胞癌相关抗原(squamous cell carcinoma antigen,SCC)、癌胚抗原(carcinoembryonic antigen,CEA)]、miR-126、miR-21水平、不良反应及生存率.结果治疗1、3个疗程后,两组FBG、2 h PBG、HbAlc水平均较治疗前下降,且研究组低于对照组,治疗3个疗程后对照组FBG、2 h PBG、HbAlc水平均高于治疗1个疗程后(P<0.05);治疗1、3个疗程后,两组血清SCC、CA724、CEA、CYFRA21-1水平均较治疗前下降,且研究组低于对照组(P<0.05);治疗1、3个疗程后,两组血清miR-126水平均较治疗前升高,血清miR-21水平均较治疗前下降,且研究组血清miR-126水平高于对照组,血清miR-21水平低于对照组(P<0.05);治疗3个疗程研究组疾病控制率(disease control rate,DCR)、客观缓解率(objective response rate,ORR)均高于对照组(P<0.05),随访1年研究组3例、对照组2例因住址变迁失访,研究组DCR高于对照组(P<0.05),两组ORR比较差异无统计学意义;随访1BACKGROUND Metformin is a first-line drug for type 2 diabetes,and paclitaxel is a commonly used chemotherapy drug for esophageal cancer.For patients with type 2 diabetes mellitus(T2DM)and esophageal cancer,both anti-tumor therapy and control of blood sugar are required.The combined application of metformin and paclitaxel chemotherapy may enhance treatment efficacy in patients with T2DM and esophageal cancer.AIM To evaluate the clinical effects of metformin combined with paclitaxel chemotherapy in patients with T2DM and esophageal cancer,and to analyze its impact on blood glucose levels and tumor markers.METHODS A total of 200 patients with T2DM and esophageal cancer admitted to our hospital from October 2018 to October 2022 were selected.These patients were divided into a study group and a control group according to the treatment plan,with 100 cases in each group.Both groups received basic glucose control and chemoradiotherapy.The control group was additionally treated with paclitaxel chemotherapy,while the study group additionally received a combination therapy of metformin and paclitaxel chemotherapy.The therapeutic effects,glucose levels[fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),and hemoglobin A1c(HbAlc)],tumor marker levels[carbohydrate antigen72-4(CA724),cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma associated antigen(SCC),and carcinoembryonic antigen(CEA)],miR-126 and miR-21 levels,adverse reactions,and survival rates were compared between the two groups.RESULTS After 1 and 3 cycles of treatment,the levels of FBG,2 h PBG,and HbAlc in both groups were lower than those before treatment,and the levels of these indexes in the study group were lower than those of the control group.The levels of FBG,2 h PBG,and HbAlc in the control group after 3 cycles of treatment were higher than those after 1 cycle of treatment(P<0.05).After 1 and 3 cycles of treatment,serum levels of SCC,CA724,CEA,and CYFRA21-1 in both groups were decreased compared with those before treatment,and these i

关 键 词：食管癌 血糖 2型糖尿病 紫杉醇化疗 二甲双胍 肿瘤标志物 

分 类 号：R73[医药卫生—肿瘤]