卡培他滨术前和术后同步放化疗对中低位直肠癌患者血清TRAIL及DEK水平的影响
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摘要
目的:分析卡培他滨术前和术后同步放化疗对中低位直肠癌患者血清肿瘤坏死因子相关凋亡配体(TRAIL)及原癌基因(DEK)水平的影响。方法:将100例中低位直肠癌依照随机信封法分为观察组及对照组;对照组采用手术+术后放化疗方案治疗,观察组采用术前放化疗+手术+巩固化疗方案治疗;随访30个月记录两组患者生存率;治疗前及治疗结束后6个月采用ELISA法检测黏膜组织中TRAIL及DEK水平。结果:治疗后观察组黏膜组织中TRAIL水平显著高于对照组(P<0.05),治疗后观察组黏膜组织中DEK水平显著低于对照组(P<0.05);观察组患者随访生存期明显优于对照组,且差异有统计学意义(P<0.05)。结论:采用卡培他滨术前和术后同步放化疗对中低位直肠癌患者治疗后可有效升高患者手术病灶部位TRAIL水平并降低DEK水平,具有较高的临床应用价值。
Objective:To analyze the effect of preoperative and postoperative concurrent chemoradiotherapy on serum TRAIL and DEK levels in patients with capecitabine.Methods:100 cases of middle and low rectal cancer were divided into observation group and control group according to random envelope method; the control group was treated with surgery plus postoperative chemotherapy and radiotherapy, the observation group was treated with preoperative chemotherapy + surgery + consolidation chemotherapy; 30 cases were followed up. The survival rates of the two groups were recorded monthly, and the levels of TRAIL and DEK in the mucosa were detected by ELISA before and 6 months after treatment.Results:The level of TRAIL in the mucosa of the observation group was significantly higher than that of the control group(P<0.05); the level of DEK in the mucosa of the observation group was significantly lower than that of the control group(P<0.05); the survival time of the observation group was significantly better than that of the control group, and the difference was statistically significant(P<0.05).Conclusions:Preoperative and postoperative concurrent chemoradiotherapy with capecitabine can effectively elevate TRAIL level and reduce DEK level in patients with middle and low rectal cancer.
Objective:To analyze the effect of preoperative and postoperative concurrent chemoradiotherapy on serum TRAIL and DEK levels in patients with capecitabine.Methods:100 cases of middle and low rectal cancer were divided into observation group and control group according to random envelope method; the control group was treated with surgery plus postoperative chemotherapy and radiotherapy, the observation group was treated with preoperative chemotherapy + surgery + consolidation chemotherapy; 30 cases were followed up. The survival rates of the two groups were recorded monthly, and the levels of TRAIL and DEK in the mucosa were detected by ELISA before and 6 months after treatment.Results:The level of TRAIL in the mucosa of the observation group was significantly higher than that of the control group(P<0.05); the level of DEK in the mucosa of the observation group was significantly lower than that of the control group(P<0.05); the survival time of the observation group was significantly better than that of the control group, and the difference was statistically significant(P<0.05).Conclusions:Preoperative and postoperative concurrent chemoradiotherapy with capecitabine can effectively elevate TRAIL level and reduce DEK level in patients with middle and low rectal cancer.
引文
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[14] 秦云, 梁莉萍, 郑兴征,等. 免疫组织化学法检测结直肠癌四种 DNA错配修复蛋白表达缺失对判断肿瘤微卫星状态的价值[J]. 中华病理学杂志, 2015, 44(10):704-708.
[2] 凌浩,董长女,傅启全.结直肠癌肺转移患者的临床特征及预后生存分析[J].中国肿瘤临床与康复,2017,24(6):718-721.
[3] Wu SG, Zhang WW, Sun JY, et al. Preoperative radiotherapy improves survival in rectal signet-ring cell carcinoma-a population-based study[J]. Radiation Oncology, 2017, 12(1):141.
[4] Gollins S, West N, Sebagmontefiore D, et al. Preoperative chemoradiation with capecitabine, irinotecan and cetuximab in rectal cancer: significance of pre-treatment and post-resection RAS mutations[J]. British Journal of Cancer, 2017, 117(9):1286-1294.
[5] 黎村艳, 张晓, 陆建国,等. 血清肿瘤坏死因子相关凋亡诱导配体与C-反应蛋白对儿童急性病毒感染的诊断价值[J]. 中华医院感染学杂志, 2016, 26(20):4724-4726.
[6] 乔明旭. 人肝细胞癌中DEK基因的转录调控机制研究[D]. 北京交通大学, 2016.
[7] Kogler P, Devries AF, Eisterer W, et al. Intensified preoperative chemoradiation by adding oxaliplatin in locally advanced, primary operable (cT3NxM0) rectal cancer : Impact on long-term outcome. Results of the phase II TAKO 05/ABCSG R-02 trial[J]. Strahlentherapie Und Onkologie, 2018, 194(1):41-49.
[8] Akgun E, Ozkok S, Tekin M, et al. The effects of chemoradiotherapy on recurrence and survival in locally advanced rectal cancers with curative total mesorectal excision: a prospective, nonrandomized study[J]. World Journal of Surgical Oncology, 2017, 15(1):205.
[9] 中华医学会肠外肠内营养学分会.肿瘤患者营养支持指南[J].中华外科杂志,2017,55(11):801-829.
[10] Maeda K, Shibutani M, Otani H,et al. Neoadjuvant radiotherapy with capecitabine plus bevacizumab for locally advanced lower rectal cancer: results of a single-institute phase II study.[J]. Anticancer Research, 2018, 38(7):4193-4197.
[11] 张梦, 阿合力·纳斯肉拉, 成芳. 术前同步放化疗联合全直肠系膜切除术治疗Ⅱ/Ⅲ期中、低位直肠癌的临床疗效[J]. 现代肿瘤医学, 2017, 25(13):2092-2097.
[12] Bruera G, Di MS, Bonfili P,et al. Dose-finding study of oxaliplatin associated to capecitabine-based preoperative chemoradiotherapy in locally advanced rectal cancer.[J]. Oncotarget, 2018, 9(25):17906.
[13] Wu AW, Cai Y, Li YH, et al. Pattern and management of recurrence of mid-low rectal cancer after neoadjuvant intensity-modulated radiotherapy: single-center results of 687 cases[J]. Clinical Colorectal Cancer, 2018, 17(2): 530.
[14] 秦云, 梁莉萍, 郑兴征,等. 免疫组织化学法检测结直肠癌四种 DNA错配修复蛋白表达缺失对判断肿瘤微卫星状态的价值[J]. 中华病理学杂志, 2015, 44(10):704-708.