卡培他滨治疗晚期胃癌对肠黏膜屏障功能及血清肿瘤标志物水平的影响
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摘要
目的探讨卡培他滨治疗晚期胃癌对肠黏膜屏障功能及血清肿瘤标志物水平的影响。方法选取晚期胃癌患者116例,根据化疗方案的不同分为研究组与对照组各58例。对照组行常规化疗,研究组在对照组的基础上应用卡培他滨。比较两组近期临床疗效,治疗前后血清二胺氧化酶(DAO)、内毒素脂多糖(LPS)水平,尿液中乳果糖与甘露醇之比(L/M),检测癌胚抗原(CEA)、癌抗原125(CA125)、糖原19-9(CA19-9)、细胞角蛋白19片段(CYFRA21-1)等肿瘤标志物水平,记录治疗过程中不良反应发生率。结果治疗后两组客观缓解率差异无显著性(P>0. 05),但研究组疾病控制率显著高于对照组,差异有显著性(P<0.05)。治疗后两组血清LPS、对照组血清中DAO水平均显著升高,且研究组均显著低于对照组,差异有显著性(P<0. 05);治疗后两组尿液中L/M水平均显著升高,且研究组显著低于对照组,差异有显著性(P<0. 05)。治疗后两组血清CEA、CA19-9、CA125、CYFRA21-1水平均显著下降,且研究组均显著低于对照组,差异有显著性(P<0. 05)。两组各项不良反应发生率差异无显著性(P>0.05)。结论卡培他滨治疗晚期胃癌对患者肠黏膜屏障功能的损伤较轻,且可更加有效地降低血清肿瘤标志物水平,从而提升化疗效果。
Objective To explore the effects of capecitabine on intestinal mucosal barrier function and serum tumor markers in patients with advanced gastric cancer. Method 116 patients with advanced gastric cancer admitted to our hospital were selected as the research subjects. Their clinical datas were retrospectively analyzed. They were divided into study group(n = 58) and control group(n = 58) according to different chemotherapy regimens. The control group was treated with routine chemotherapy, and the study group was treated with capecitabine on the basis of the control group. The short-term clinical efficacy of the two groups were compared; intestinal mucosal barrier function of the two groups before and after treatment were compared; the serum tumor markers of the two groups before and after treatment were detected and compared; the incidence of toxic and side effects during treatment was recorded.Result There was no significant difference in ORR between the two groups after treatment( P>0. 05), but DCR in the study group was significantly higher than that in the control group(P<0. 05). After treatment, the serum LPS level in the two groups, the serum DAO level in the control group were significantly higher than that before treatment, but the study group was significantly lower than the control group(P<0.05); After treatment, the urine levels of L/M in both groups were significantly increased, but the study group was significantly lower than the control group(P<0.05). After treatment, the serum CEA, CA19-9, CA125 and CYFRA21-1 levels in the two groups decreased significantly, and the study group was significantly lower than the control group( P<0. 01). There was no significant difference in the incidence of toxic and side effects between the two groups( P>0. 05). Conclusion Capecitabine in the treatment of advanced gastric cancer has less damage to intestinal mucosal barrier function, and can reduce serum tumor markers more effectively, so as to improve the effect of chemotherapy.
Objective To explore the effects of capecitabine on intestinal mucosal barrier function and serum tumor markers in patients with advanced gastric cancer. Method 116 patients with advanced gastric cancer admitted to our hospital were selected as the research subjects. Their clinical datas were retrospectively analyzed. They were divided into study group(n = 58) and control group(n = 58) according to different chemotherapy regimens. The control group was treated with routine chemotherapy, and the study group was treated with capecitabine on the basis of the control group. The short-term clinical efficacy of the two groups were compared; intestinal mucosal barrier function of the two groups before and after treatment were compared; the serum tumor markers of the two groups before and after treatment were detected and compared; the incidence of toxic and side effects during treatment was recorded.Result There was no significant difference in ORR between the two groups after treatment( P>0. 05), but DCR in the study group was significantly higher than that in the control group(P<0. 05). After treatment, the serum LPS level in the two groups, the serum DAO level in the control group were significantly higher than that before treatment, but the study group was significantly lower than the control group(P<0.05); After treatment, the urine levels of L/M in both groups were significantly increased, but the study group was significantly lower than the control group(P<0.05). After treatment, the serum CEA, CA19-9, CA125 and CYFRA21-1 levels in the two groups decreased significantly, and the study group was significantly lower than the control group( P<0. 01). There was no significant difference in the incidence of toxic and side effects between the two groups( P>0. 05). Conclusion Capecitabine in the treatment of advanced gastric cancer has less damage to intestinal mucosal barrier function, and can reduce serum tumor markers more effectively, so as to improve the effect of chemotherapy.
引文
[1]张惠,时建明,朱凡.紫杉醇脂质体治疗晚期胃癌的疗效及对患者血清肿瘤标志物的影响[J].癌症进展,2018, 16(10):1261-1263.
[2]陈之白,黄源,覃新干,等.胃癌根治术中采用腹腔化疗对加速康复影响的临床研究[J].中国临床医生杂志,2018,46(7):813-815.
[3]许震,左云,陆筱灵.卡培他滨联合奥沙利铂治疗进展期老年胃癌的应用价值分析[J].中国医刊,2015,50(11):84-86.
[4]黄慧云,黄兵,李斌,等.奥沙利铂联合卡培他滨治疗晚期胃癌的价值分析[J].中国医药,2014,9(12):1765-1767.
[5]王竞,王金万.胃癌的诊断与治疗(二)——晚期胃癌的治疗现状[J].中国全科医学,2004, 10(22):1631-1634.
[6]郑礼平,张楠,潘莹,等.晚期胃癌卡培他滨或替吉奥维持治疗的临床研究[J].实用医学杂志,2017, 33(16):2757-2760.
[7] Eisenhauer EA, Verweij J, Eisenhauer EA, et al. 11 New response evaluation criteria in solid tumors:RECIST GLIDELINE VERSION1.1[J]. Ejc Supplements, 2009, 7(2):5.
[8]徐继业,徐克友,左彩莹,等.多西紫杉醇联合顺铂二线化疗对进展期晚期胃癌患者临床疗效研究[J].贵州医药,2016, 40(6):572-574.
[9] Feng Z, Chen L, Liu Z, et al. DCF intraperitoneal and intravenousdual chemotherapy regimen for advanced gastric cancer:A feasibility study[J]. Oncology Letters, 2015, 9(1):491-497.
[10]韩惠萍,张丽娇,董洁晨,等.复方谷氨酰胺肠溶胶囊联合葛根芩连汤防治晚期结直肠癌FOLFIRI方案化疗相关性腹泻疗效及对肠黏膜通透性和免疫细胞因子的影响[J].现代中西医结合杂志,2017, 3(33):3669-3673.
[11]余金喜,李耀宗.依立替康联合卡培他滨治疗晚期胃癌的临床观察[J].药品评价,2012(27):36-39.
[12]韩惠娟,高忠媛.卡培他滨联合顺铂与氟尿嘧啶联合顺铂治疗晚期胃癌的对比研究[J].中国临床医生杂志,2018,46(4):450-452.
[13]王树滨,吴煊,陈晓秋,等.卡培他滨和替吉奥作为晚期胃癌一线诱导化疗后维持治疗的临床观察[J].中国肿瘤临床,2016,43(20):913-917.
[14]耿春艳,蔡蔚,陈斌.XELOX方案与PF方案治疗老年进展期食管癌的对比研究[J].临床误诊误治,2013,26(9):71-73.
[15]林丹丹,张一桥,陈能,等.卡培他滨联合奥沙利铂对比氟尿嘧啶联合奥沙利铂治疗结直肠癌疗效与安全性的Meta分析[J].中国肿瘤,2016, 25(11):927-932.
[2]陈之白,黄源,覃新干,等.胃癌根治术中采用腹腔化疗对加速康复影响的临床研究[J].中国临床医生杂志,2018,46(7):813-815.
[3]许震,左云,陆筱灵.卡培他滨联合奥沙利铂治疗进展期老年胃癌的应用价值分析[J].中国医刊,2015,50(11):84-86.
[4]黄慧云,黄兵,李斌,等.奥沙利铂联合卡培他滨治疗晚期胃癌的价值分析[J].中国医药,2014,9(12):1765-1767.
[5]王竞,王金万.胃癌的诊断与治疗(二)——晚期胃癌的治疗现状[J].中国全科医学,2004, 10(22):1631-1634.
[6]郑礼平,张楠,潘莹,等.晚期胃癌卡培他滨或替吉奥维持治疗的临床研究[J].实用医学杂志,2017, 33(16):2757-2760.
[7] Eisenhauer EA, Verweij J, Eisenhauer EA, et al. 11 New response evaluation criteria in solid tumors:RECIST GLIDELINE VERSION1.1[J]. Ejc Supplements, 2009, 7(2):5.
[8]徐继业,徐克友,左彩莹,等.多西紫杉醇联合顺铂二线化疗对进展期晚期胃癌患者临床疗效研究[J].贵州医药,2016, 40(6):572-574.
[9] Feng Z, Chen L, Liu Z, et al. DCF intraperitoneal and intravenousdual chemotherapy regimen for advanced gastric cancer:A feasibility study[J]. Oncology Letters, 2015, 9(1):491-497.
[10]韩惠萍,张丽娇,董洁晨,等.复方谷氨酰胺肠溶胶囊联合葛根芩连汤防治晚期结直肠癌FOLFIRI方案化疗相关性腹泻疗效及对肠黏膜通透性和免疫细胞因子的影响[J].现代中西医结合杂志,2017, 3(33):3669-3673.
[11]余金喜,李耀宗.依立替康联合卡培他滨治疗晚期胃癌的临床观察[J].药品评价,2012(27):36-39.
[12]韩惠娟,高忠媛.卡培他滨联合顺铂与氟尿嘧啶联合顺铂治疗晚期胃癌的对比研究[J].中国临床医生杂志,2018,46(4):450-452.
[13]王树滨,吴煊,陈晓秋,等.卡培他滨和替吉奥作为晚期胃癌一线诱导化疗后维持治疗的临床观察[J].中国肿瘤临床,2016,43(20):913-917.
[14]耿春艳,蔡蔚,陈斌.XELOX方案与PF方案治疗老年进展期食管癌的对比研究[J].临床误诊误治,2013,26(9):71-73.
[15]林丹丹,张一桥,陈能,等.卡培他滨联合奥沙利铂对比氟尿嘧啶联合奥沙利铂治疗结直肠癌疗效与安全性的Meta分析[J].中国肿瘤,2016, 25(11):927-932.