新辅助化疗对胃癌组织中p53、APC、C-erBb-2和CEA表达水平的影响分析

The effects of neoadjuvant chemotherapy on expressions of p53,APC,C-erBb-2 and CEA in gastric cancer tissue

目的研究新辅助化疗对胃癌组织中p53、APC、C-erBb-2和癌胚抗原（CEA）表达水平的影响。方法将2013年7月至2014年7月于本院就诊的进展期（Ⅲ期）胃癌患者112例随机分为观察组与对照组,每组各56例。观察组患者行术前新辅助化疗（neoadiuvant chemotherapy,NAC）,采用奥沙利铂＋替吉奥化疗2~4个周期,化疗后2~3周行手术治疗。对照组患者行单纯手术治疗。术后采用免疫组织化学法检测患者胃癌组织中p53、APC及C-erBb-2表达水平,采用酶联免疫吸附测定（ELISA）检测CEA表达水平,并进行统计学分析。结果观察组患者术后p53、APC、C-erBb-2及CEA表达水平均较术前下降（P〈0.05）,对照组患者术后p53、APC、C-erBb-2及CEA表达水平与术前比较差异均无显著性（P〉0.05）。观察组患者死亡11例,存活45例,存活率为80.4%;对照组患者死亡23例,存活33例,存活率为58.9%。两组患者存活率比较差异具有显著性（P〈0.05）。结论新辅助化疗能够降低胃癌组织中p53、APC、C-erBb-2和CEA的表达水平,可以辅助改善患者的预后,为胃癌的综合治疗提供理论基础。

Objective To explore the effects of neoadjuvant chemotherapy on the expressions of p53,APC,C-erBb-2 and carcino-embryonic antigen（CEA）.Method 112 gastric patients at progressive stage（stage Ⅲ）admitted in our hospital from July 2013 to July 2014 were selected and randomly divided into observation group and control group,56 patients in each group.Observation group patients received neoadjuvant cheomtherapy（oxaliplatin ＋ S-l） for 2 ~ 4 cycles first and 2 ~ 3 weeks later the patients received surgery.Control group patients only received surgery.After that,immunohistochemistry was used to detect the expressions of p53,APC and C-erBb-2,enzyme linked immunosorbent assay（ELISA） was used to detect CEA.All the data were analyzed.Result The expression levels of p53,APC,C-erBb-2 and CEA had significant decreased after surgery in observation group（P 〈0.05）;the expression levels of p53,APC,C-erBb-2 and CEA after surgery were not statistically different from before surgery in control group（P 〉0.05）;11 patients died and 45 patients survived in observation group,the survival rate was 80.4%;23 patients died and 33 patients survived in control group,the survival rate was 58.9%,the survival rates were statistically different between the two groups（P 〈0.05）.Conclusion Neoadjuvant cheomtherapy can decrease the expression levels of p53,APC,C-erBb-2and CEA in gastric cancer patients,and can improve the prognosis of gastric patients,which may provides a theoretical basis for the comprehensive treatment of gastric cancer.