胃癌合并腹水患者接受S-1联合DDP腹腔恒温循环热灌注治疗后病情进展情况评估

Effect of S-1 combined with DDP coelom continued circulatory hyperthermia perfusion on gastric cancer patients with ascites

目的:分析胃癌合并腹水患者接受S-1联合DDP腹腔恒温循环热灌注治疗后病情进展情况。方法:78例胃癌伴腹水患者分为接受腹腔恒温循环热灌注治疗的观察组38例,接受传统腹腔热灌注化疗的对照组40例。治疗后采用ELISA法测定两组血浆及腹水病情相关因子水平,RT-PCR法测定腹腔灌洗液肿瘤相关分子mRNA表达量。结果:观察组血浆及腹水中ICAM-1、PTN、IL-16、Exosome水平低于对照组,差异具有统计学意义(P<0.05);腹腔灌洗液Beclin-1、PIK3CD、CK19、CK-20、CEA mRNA表达量均低于对照组,差异具有统计学意义(P<0.05);Fas、caspase-3、Apaf-1等凋亡分子mRNA表达量均高于对照组,差异具有统计学意义(P<0.05);miRNA-497、miRNA-936的mRNA表达量低于对照组,miRNA-145、miRNA-181b表达量高于对照组,差异均具有统计学意义(P<0.05)。结论:S-1联合DDP腹腔恒温循环热灌注可优化胃癌合并腹水患者病情,有助于肿瘤恶性程度的降低,具有积极的临床意义。

Objective： To analyze effect of S-1 combined with DDP coelom continued circulatory hyperthermia perfusion on gastric cancer patients with ascites. Methods： A total of 78 gastric cancer patients with ascites were divided into observation group 38 cases undergoing coelom continued circulatory hyperthermia perfusion and control group 40 cases undergoing traditional hyperthermic intraperitoneal chemotherapy. ELISA method was used after treatment to determine the levels of illness-related factors in plasma and ascites,and RT-PCR was used to determine the mRNA expression levels of tumor-related molecules in peritoneal lavage fluids of two groups. Results： ICAM-1,PTN,IL-16 and Exosome levels in serum and ascites of observation group were lower than those of control group（ P〈0. 05）; mRNA expression levels of Beclin-1,PIK3 CD,CK19,CK-20 and CEA in peritoneal lavage fluids were lower than those of control group（ P〈0. 05）; mRNA expression levels of apoptosis molecules Fas,caspase-3 and Apaf-1 were higher than thoseof control group（ P〈0. 05）; mRNA expression levels of miRNA-497 and miRNA-936 were lower than those of control group,and expression levels of miRNA-145 and miRNA-181 b were higher than those of control group（ P〈0. 05）. Conclusions： S-1 combined with DDP coelom continued circulatory hyperthermia perfusion can optimize the illness in gastric cancer patients with ascites and help to reduce the malignant degree of tumor,and it has positive clinical significance.