FOLFOX 新辅助化疗对胃癌组织 P53蛋白和 VEGF 表达的影响

Effect of FOLFOX neoadjuvant chemotherapy on P53 protein and VEGF expression on gastric cancer

目的：观察 FOLFOX 新辅助化疗对胃癌组织 P53蛋白和血管内皮生长因子（VEGF）表达的影响。方法选择86例胃癌患者做为研究对象，对照组43例仅采用手术治疗，观察组43例术前采用 FOLFOX 新辅助化疗，评价两组手术效果。化疗前后用免疫组化法测定胃癌组织 P53蛋白和 VEGF 的表达。结果观察组 R0切除率和D2淋巴结清扫率明显高于对照组（P ﹤0.05）。观察组化疗后肿瘤平均直径明显减少，治疗前后比较差异有统计学意义（P ﹤0.05），化疗总有效率为53.5%。观察组不良反应主要有白细胞减少、恶心及感觉神经毒性，大部分反应均轻微。观察组化疗前胃癌组织 P53阳性率为58.1%，VEGF 阳性率为76.7%；化疗后 P53阳性率为32.6%， VEGF 阳性率为30.2%。化疗后 P53和 VEGF 阳性率均明显降低（P ﹤0.01）。结论 FOLFOX 新辅助化疗可以明显减少胃癌组织 P53蛋白和 VEGF 的表达，从而提高手术疗效。

Objective To study the effect of FOLFOX neoadjuvant chemotherapy on P53 protein and vascular endothelial growth factor（VEGF）expression in patients with gastric cancer. Methods Eighty-six patients with gastric cancer were enrolled as study object. The 43 cases in control group were treated with surgery only and 43 cases in the observation group were given FOLFOX neoadjuvant chemo-therapy before surgery. The surgical results were evaluated. P53 protein and VEGF expression in gastric carcinoma were detected by immunohistochemistry before and after chemotherapy. Results In the obser-vation group,the R0 resection rate and D2 lymph node dissection rate was significantly higher than that in the control group（P ﹤ 0. 05）. In the observation group,the average diameter of the tumor after chemo-therapy was significantly reduced,there was significant difference before and after treatment（P ﹤ 0. 05）. The total effective rate of chemotherapy was 53. 5% . The adverse reactions mainly were neutropenia, nausea and sensory nerve toxicity, most reactions were mild. Before chemotherapy,the P53 positive rate was 58. 1% ,the VEGF positive rate was 76. 7% in gastric carcinoma tissue of the ob-servation group;after chemotherapy,the P53 positive rate was 32. 6% ,the VEGF positive rate was 30. 2% of the observation group. The P53 and VEGF positive rate was significantly lower after chemo-therapy（P ﹤ 0. 01）. Conclusions FOLFOX neoadjuvant chemotherapy can obviously decrease P53 pro-tein and VEGF expression in gastric carcinoma tissue,so as to improve the surgery effect.