摘要
目的探索晚期胃癌患者血清中可以预测化疗疗效的标志物。方法共选取42例初治晚期胃腺癌患者,采用DCF方案(多西他赛+顺铂+氟尿嘧啶)一线化疗。于治疗开始前以及每2周期结束后抽取外周静脉血,直至出现进展或不可耐受的副反应。ELISA法检测患者血清中人富含半胱氨酸的酸性分泌蛋白(SPARC)、Dickkopf1(DKK-1)以及人血管内皮生长因子(VEGF)的蛋白表达水平。结果血清中SPARC蛋白的差异表达出现在敏感组和原发耐药组患者间,VEGF蛋白的差异表达出现在敏感组患者化疗前后以及原发耐药患者化疗前后。各组间未观察到DKK-1水平的显著差异。结论胃癌患者血清中SPARC水平可以作为DCF方案化疗疗效的预测指标,VEGF水平的变化与化疗疗效有关。
Objective To determine the prognostic value of the serum protein for chemotherapy in patients with advanced gastric cancer.Methods Forty-two advanced gastric adenocarcinoma patients without prior chemotherapy or prior radiotherapy were eligible for this study,and were treated with DCF（docetaxel＋cisplatin＋5-fluorouracil） as the first line treatment.Responses to chemotherapy in measurable lesions were evaluated after 2 cycles according to RECIST and were classified as complete response（CR）,partial response（PR）,stable disease（SD）,or progressive disease（PD）.Patients who achieved CR,PR,or SD were defined as chemosensitive group and patients with PD were defined as chemoresistant group.Patients in chemosensitive group continued DCF chemotherapy for another 2 cycles until radiologic evidence of disease progression or unacceptable side toxicities.All patients accepted DCF chemotherapy for no more than six cycles.Blood sample were obtained before the chemotherapy and every two cycles until disease progression.The expressions of SPARC,DKK-1 and VEGF in serum were examined by ELISA.Results After two cycles of chemotherapy,PD was observed in 25 patients who were defined as primary chemoresistant group.The rest 17 patients（no patients showed CR,12 patients showed PR and 5 patients showed SD） were defined as chemosensitive group and continued the chemotherapy until disease progression.Among them,12 patients showed PD during the subsequent chemotherapy and were defined as acquired chemoresistace group.The different expression of SPARC were observed in the chemosensitive group and primarily chemoresistant group（628.0±132.5） ng/ml vs.（475.9±122.1） ng/ml,（P〈0.001）.The level of VEGF decreased significantly（583.9±222.1） pg/ml vs.（321.3±108.3） pg/ml,（P〈0.001）.And increased significantly when disease progression（524.1±151） pg/ml vs.（670.9±160.0） pg/ml,（P=0.001）.No significant change of the level of DKK-1 was observed in patients with different response to chemotherapy.Conclusion ELISA for SPARC may be useful in prediction of the clinical reaction in advanced gastric cancer patients treated with DCF,and the change of VEGF in the serum of the patients correlates with the clinical reaction.
出处
《临床肿瘤学杂志》
CAS
2010年第3期242-245,共4页
Chinese Clinical Oncology
基金
无锡市科技局指导性课题(CSZ00834)
