紫杉醇联合氟尿嘧啶对晚期胃癌患者肿瘤标志物水平及免疫功能的影响

Effect of paclitaxel combined with fluorouracil on levels of tumor markers and immune function in patients with advanced gastric cancer

目的 探讨紫杉醇与氟尿嘧啶联合治疗对晚期胃癌患者肿瘤标志物、免疫功能的影响。方法 回顾性分析2016年4月至2018年8月在本院治疗的96例晚期胃癌患者的临床资料,依据上述入选者治疗方案的不同,分为对照组(紫杉醇+卡培他滨,48例)与观察组(紫杉醇+氟尿嘧啶,48例),比较两组治疗前后肿瘤标志物[癌胚抗原(CEA)、糖类抗原(CA19-9)、细胞角蛋白19片段(CYFRA21-1)]、免疫功能变化情况与不良反应。结果 治疗3个周期后,观察组CEA、CA19-9及CYFRA21-1含量分别为(21.11±3.56)ng/ml、(32.57±4.91)U/ml、(4.55±1.82)ng/ml,均低于对照组的(33.25±4.28)ng/ml、(50.96±6.18)U/ml、(7.01±2.17)ng/ml,差异均有统计学意义(均P<0.05);治疗3个周期后,观察组CD3+、CD4+与CD4+/CD8+值分别为(60.92±6.43)%、(41.30±4.75)%、(1.53±0.25)均高于对照组的(56.34±6.51)%、(36.37±3.32)%、(1.17±0.22),CD8+值为(26.95±2.78)%低于对照组的(30.96±3.51)%,差异均有统计学意义(均P<0.05);观察组不良反应发生率为8.33%,对照组为10.42%,组间比较差异无统计学意义(P>0.05)。结论 与紫杉醇、卡培他滨联合治疗效果相较而言,晚期胃癌患者通过紫杉醇与氟尿嘧啶联合治疗,可有效调节患者免疫功能,利于控制肿瘤标志物含量,具有一定安全性。

Objective To investigate the effect of paclitaxel combined with fluorouracil on tumor markers and immune function in patients with advanced gastric cancer. Methods The clinical data of 96 patients with advanced gastric cancer treated in our hospital from April, 2016 to August, 2018 were retrospectively analyzed. According to different treatment schemes, the patients were divided into a control group (taxol + capecitabine, 48 cases) and an observation group (taxol + fluorouracil, 48 cases). The tumor markers [carcino embryonic antigen (CEA), carbonhydrate antigen 19-9 (CA19-9), and cytokeratin-19-fragment (CYFRA21-1)] and changes in immune function were compared between the two groups before and after treatment. Results After three cycles of treatment, the contents of CEA, CA19-9, and CYFRA21-1 in the observation group were (21.11±3.56) ng/ml,(32.57±4.91) U/ml, and (4.55±1.82) ng/ml, which were lower than those in the control group [(33.25±4.28) ng/ml,(50.96±6.18) U/ml, and (7.01±2.17) ng/ml;all P < 0.05]. After three cycles of treatment, the CD3^+, CD4^+, CD4^+/CD8^+, and CD8^+ in the observation group were better than those in the control group [(60.92±6.43)% vs.(56.34±6.51)%,(41.30±4.75)% vs.(36.37±3.32)%,(1.53±0.25) vs.(1.17±0.22), and (26.95±2.78)% vs.(30.96±3.51)%;all P < 0.05]. The incidence of adverse reactions was 8.33% in the observation group, and 10.42% in the control group (P > 0.05). Conclusion Compared with paclitaxel combined with capecitabine, paclitaxel combined with fluorouracil can effectively regulate the immune function of patients with advanced gastric cancer and help control the content of tumor markers.