替吉奥联合奥沙利铂新辅助化疗对进展期胃癌患者基质金属蛋白酶-9和血管内皮生长因子的影响

DeFazio capsules oxaliplatin neoadjuvant chemotherapy on matrix metalloproteinase-9 and vascular endothe-lial growth factor in patients with advanced gastric cancer

目的：探讨替吉奥胶囊联合奥沙利铂新辅助化疗对进展期胃癌患者基质金属蛋白酶-9（MMP-9）和血管内皮生长因子（VEGF）的影响。方法92例进展期胃癌患者按照数字表法随机分为两组，观察组46例，对照组46例，均采用术前新辅助化疗，观察组采用替吉奥胶囊联合奥沙利铂化疗，对照组采用卡培他滨联合奥沙利铂化疗。采用免疫组化测定胃癌组织中MMP-9和VEGF的表达。结果化疗后对照组总有效率为60．9％，观察组总有效率为80．4％，观察组总有效率明显高于对照组（χ2＝6．42，P＜0．05）。两组患者贫血、血小板减少、肝功能损害、肾功能损害、恶心呕吐的发生率比较差异无统计学意义（χ2＝1．52、0．96、2.06、0．00、1．28，均P＞0．05），观察组患者白细胞减少、神经毒性少于对照组（χ2＝5．68、4．18，均P＜0．05）。对照组化疗前VEGF和MMP-9的表达阳性率分别为93．5％、78．3％，观察组分别为89．1％和82．6％，两组差异无统计学意义（χ2＝2．12、2，72，均P ＞0．05）。化疗后对照组 VEGF 和 MMP-9的表达阳性率分别为45.7％、41.3％，观察组VEGF和MMP-9的表达阳性率分别为23．9％和21．7％，两组化疗后VEGF和MMP-9的表达阳性率均明显小于化疗前（χ2＝4．72、4．08、10．14、9．84，P＜0．05，P＜0．01），观察组比对照组降低更明显（χ2＝5．14、4.72，均P＜0．05）。结论替吉奥胶囊联合奥沙利铂新辅助化疗可以明显降低进展期胃癌患者MMP-9和VEGF的表达。

Objective To study DeFazio capsules oxaliplatin neoadjuvant chemotherapy on matrix metallo-proteinase-9 （ MMP-9 ） and vascular endothelial growth factor （ VEGF ） in patients with advanced gastric cancer . Methods 92 patients with advanced gastric cancer were randomly divided into the two groups ,the observation group （ n=46 ） and the control group （ n=46 ） .Both two groups were used neoadjuvant chemotherapy , DeFazio capsules oxaliplatin chemotherapy for the observation group and capecitabine oxaliplatin chemotherapy for the control group . Expression of MMP-9 and VEGF was determined by immunohistochemistry in gastric cancer tissues .Results After chemotherapy,the total effective rate was 60.9%in the control group and 80.4%in the observation group.The total effective rate of the observation group was significantly higher （χ2 =6.42,P〈0.05）.The anemia,thrombocyto-penia,hepatic dysfunction ,renal dysfunction ,the incidence of nausea and vomiting had no significant differences be-tween the two groups （χ2 =1.52,0.96,2.06,0.00,1.28,all P〉0.05）.Neutropenia,neurotoxicity in the observation group were less than the control group （χ2 =5.68,4.18,all P〈0.05）.Before chemotherapy,the positive rates of VEGF and MMP-9 expression in the control group were 93.5%,78.3%.Those of the observation group were 89.1%and 82.6%,respectively,the differences were not significant （χ2 =2.12,2,72,all P〉0.05）.After the chemothera-py,the positive expression rates of VEGF and MMP-9 in the control group were 45.7%,41.3%,respectively.Those of the observation group were 23.9%and 21.7%,respectively.VEGF and MMP-9 positive expression rates were sig-nificantly lower than before chemotherapy （χ2 =4.72,4.08,10.14,9.84,P〈0.05,P〈0.01）.The observation group was significantly lower than the control group （χ2 =5.14,4.72,all P〈0.05）.Conclusion DeFazio capsules oxali-platin neoadjuvant chemotherapy can decrease MMP-9 and VEGF expression in patients with advanced gastric cancer .