Cox-2选择性抑制剂预防结直肠癌术后复发的作用

Effects of selective Cox-2 inhibitor in preventing postoperative recurrence of colorectal cancer

目的探讨Cox-2选择性抑制剂预防结直肠癌术后复发的作用。方法52例患者经手术和术后病理证实为结直肠腺癌(不晚于T3N0M0期),免疫组化检测Cox-2表达阳性,随机分为对照组(n=30)和试验组(n=22)。对照组术后2周单纯按folfox-4方案化疗6个疗程;试验组术后1周起口服塞来昔布(200 mg,qd)持续1年,术后2周后同样按folfox-4方案化疗6个疗程。比较两组患者手术时、术后6个月及术后1年的肠镜活检标本Cox-2、Bcl-2和血管内皮生长因子(VEGF)的表达情况,并比较3年生存率和复发率。结果试验组患者术后1年时Cox-2、Bcl-2和VEGF阴性表达率较6个月时明显增加(P<0.05);对照组患者术后6个月时Cox-2、Bcl-2和VEGF弱表达和阴性表达率与术后1年时比较,差异无统计学意义(P>0.05)。两组患者3年生存率无统计学差异(P>0.05),但试验组患者的3年复发率显著低于对照组(P<0.05)。结论Cox-2选择性抑制剂显著降低Cox-2、Bcl-2和VEGF的表达,并降低结直肠癌术后的3年复发率,有可能成为预防结直肠癌术后复发的一种新方法。

Objective To study the effect of selective Cox-2 inhibitor in preventing the postoperative recurrence of colorectal cancer. Methods Fifty-two patients diagnosed as colorectal cancer by both operation and pathology（expressing Cox-2 and no later than stage T3N0M0） were divided into two groups randomly.Among them,30 patients（control group） received six courses of chemotherapy（folfox-4） two weeks later after operation;the other 22 patients（experimental group） took celexocib（200 mg,qd） one week later after operation for one year and also received the same six courses of chemotherapy as the other 30 patients.Two group patients＇ 3-year survival rates,recurrent rates and expression of Cox-2,Bcl-2 and VEGF were compared respectively. Results The negative or down-regulated expression of Cox-2,Bcl-2 and VEGF were observed in patients in experimental group（P〈0.05）,while no changes was observed in the control group（P〉0.05）.No significant difference was seen in the two groups about 3-year survival rates（P〉0.05）,but the 3-year recurrent rates were significantly different（P〈0.05）. Conclusion Selective Cox-2 inhibitor decreases the expression of Cox-2,Bcl-2 and VEGF and the 3-year recurrent rates of colorectal cancer significantly.It could be a new adjuvant therapy in preventing the recurrence of colorectal cancer after operation.