抗幽门螺杆菌疗法联合新辅助化疗对胃癌术后疗效及患者血清VEGF、bFGF的影响

Effect of anti-Helicobacter pylori therapy combined with neoadjuvant chemotherapy on serum VEGF and bFGF in postoperative patients with gastric cancer

目的:研究抗幽门螺杆菌(HP)疗法联合FOLFOX4化疗对胃癌术后患者血清血管内皮生长因子(VEGF)、成纤维细胞生长因子(bFGF)影响及治疗疗效。方法:收集胃癌根治术后患者80例,入组前均进行碳14呼气试验,均为HP阳性患者,随机数字分组法分为试验组和对照组,每组各40例。对照组仅进行FOLFOX4化疗,每2周1次,维持8~12次;试验组在上述基础上加用抗幽门螺杆菌治疗。比较两组间及治疗前后各时段血清VEGF、bFGF水平变化。对比两组无进展生存期(PFS)、总生存期(OS)及治疗期间不良反应情况。结果:两组患者治疗1个月、3个月、6个月、12个月时血清VEGF、bFGF值均呈明显下降趋势,且试验组治疗1个月、3个月、6个月、12个月时血清VEGF、bFGF值均较对照组数值下降更明显(P<0.05)。试验组PFS及OS明显长于对照组(P<0.05)。治疗期间试验组Ⅰ~Ⅱ级恶心呕吐及感觉神经病变发生例数显著多于对照组(P<0.05)。结论:抗HP联合FOLFOX4化疗有效延长患者PFS和OS,安全性高,可有效提高患者生存质量。这可能与其能抑制肿瘤局部新生血管生成,抑制肿瘤细胞局部复发和转移等机制有关。

Objective:To study the effect of anti-Helicobacter pylori(HP) therapy combined with FOLFOX4 chemotherapy on serum vascular endothelial growth factor(VEGF) and fibroblast growth factor(bFGF) in patients with gastric cancer after operation and its therapeutic effect.Method:80 patients with radical gastrectomy were enrolled. All patients underwent carbon 14 breath test before the enrollment, all were infected with HP. All patients were divided into experimental group and control group by the randomized digital grouping method, with 40 cases in each group.In the control group, only FOLFOX4 chemotherapy was performed, once every 2 weeks, and maintained 8 to 12 times;the experimental group was treated with anti-Helicobacter pylori on the above basis. The levels of serum VEGF and bFGF were compared between the two groups and before and after treatment.The progression-free survival(PFS), overall survival(OS), and adverse events during treatment were compared between the two groups.Results: During the treatment period, serum VEGF and bFGF levels of two groups decreased significantly at 1 month, 3 months, 6 months, and 12 months, and the serum VEGF and bFGF levels in the experimental group were significantly lower than those in the control group at 1 month, 3 months, 6 months and 12 months(P<0.05).PFS and OS in the experimental group were significantly longer than the control group(P<0.05). During the treatment period, the number of cases of grade I^II nausea and vomiting and sensory neuropathy in the experimental group was significantly higher than that in the control group(P<0.05).Conclusion:Anti-Hp combined with FOLFOX4 chemotherapy can effectively prolong PFS and OS, and it is safe and can improve the quality of life of patients. This may be related to its ability to inhibit local neovascularization of tumors, inhibit local recurrence and metastasis of tumor cells.