贝伐单抗联合奥沙利铂、亚叶酸钙、氟尿嘧啶化疗对ⅢB~Ⅳ期胃癌癌胚抗原和糖类抗原199水平的影响

Effect of bevacizumab combined with oxaliplatin,calcium folinate and fluorouracil chemotherapy on carcinoembryonic antigen and carbohydrate antigen 199 levels in patients with stageⅢB-Ⅳgastric cancer

目的分析贝伐单抗联合奥沙利铂、亚叶酸钙和氟尿嘧啶(FOLFOX)化疗对ⅢB~Ⅳ期胃癌患者癌胚抗原(CEA)、糖类抗原199(CA199)水平及中位生存期(MST)的影响。方法选取收治的68例ⅢB~Ⅳ期胃癌患者,采用简单随机化法均分为2组,对照组给予FOLFOX化疗,观察组予以贝伐单抗联合FOLFOX化疗,比较2组治疗3个周期后的疾病控制率、缓解率、糖类抗原724(CA724)、CEA、CA199、糖类抗原242(CA242)、糖类抗原125(CA125)、糖类抗原153(CA153)、人血管内皮细胞生长因子受体1(VEGFR-1)、血管内皮细胞生长因子-A(VEGF-A)、血管内皮生长因子-D(VEGF-D)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、MST和中位疾病进展时间(TTP)。结果治疗3个周期后,观察组疾病控制率(82.35%)和缓解率(67.65%)均高于对照组(58.82%和41.18%)(P<0.05);观察组治疗3个周期后CEA、CA199、CA724、CA242、CA125和CA153均低于对照组(P<0.05);观察组VEGFR-1和VEGF-A低于对照组,VEGF-D高于对照组(P<0.05);观察组治疗后MMP-2和MMP-9均低于治疗前,且低于对照组(P<0.05);观察组MST和TTP长于对照组(P<0.05)。结论贝伐单抗联合FOLFOX化疗治疗ⅢB~Ⅳ期胃癌,可增强对肿瘤新生血管的抑制作用,降低血清肿瘤标志物水平与肿瘤细胞转移、侵袭能力,提高疾病缓解率与控制率,延长患者MST和TTP。

Objective To analyze the effects of bevacizumab combined with oxaliplatin,calcium folinate and fluorouracil(FOLFOX)chemotherapy on carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)and median survival time(MST)in patients with stageⅢB-Ⅳgastric cancer.Methods 68 patients with stageⅢB-Ⅳgastric cancer were enrolled.The patients were randomly divided into 2 groups.The control group received FOLFOX chemotherapy,while the observation group received bevacizumab combined with FOLFOX chemotherapy.The disease control rate,remission rate,carbohydrate antigen 724(CA724),CEA,CA199,carbohydrate antigen 242(CA242),carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153),human vascular endothelial growth factor receptor 1(VEGFR-1),vascular endothelial growth factor-A(VEGF-A),vascular endothelial growth factor-D(VEGF-D),matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),MST and the time to tumor progression(TTP)were compared after 3 cycles between the 2 groups.Results After 3 cycles of treatment,the disease control rate and remission rate(82.35%and 67.65%)in observation group were higher than those in control group(58.82%and 41.18%)(P<0.05).The observation group received CEA,CA199,CA724,CA242,CA125 and CA153 after 3 cycles were lower than the control group(P<0.05);the VEGFR-1 and VEGF-A in the observation group were lower than in control group,and the VEGF-D was higher than control group(P<0.05);MMP-2 and MMP-9 was lower than that before treatment and lower than control group(P<0.05).MST and TTP in the observation group were longer than in control group(P<0.05).Conclusion Bevacizumab combined with FOLFOX chemotherapy in the treatment of stageⅢB-Ⅳgastric cancer can enhance the inhibition of tumor neovascularization,reduce serum tumor marker levels and tumor cell metastasis,invasion ability,improve disease remission rate and control rate,and prolong MST and TTP.