胃饥饿素与胃癌手术后化疗相关性恶心呕吐的关系研究

Study on the relationship between ghrelin and chemotherapy-induced nausea and vomiting after operation for gastric cancer

目的探讨胃饥饿素(Ghrelin)水平的变化与胃癌手术后化疗相关性恶心呕吐(CINV)发生的关系。方法选择确诊并行根治性胃癌切除术患者90例,手术后第3周进行化学治疗2周(1个疗程),均采用FOLFOX4化疗方案。将化疗后出现恶心呕吐的患者设定为CINV组(n=61),未出现恶心呕吐的患者设定为非CINV组(n=29)。全组患者分别于化疗前1 d及化疗开始后第2、4、7、14 d采用ELISA法检测血浆Ghrelin表达水平,比较并分析两组化疗前后Ghrelin水平变化和化疗相关性恶心呕吐(CINV)发生的关系。结果CINV组患者血浆Ghrelin表达水平在化疗后第2、4 d较化疗前明显下降,差异具有统计学意义(p<0.01);而非CINV组血浆Ghrelin表达水平在化疗后第2、4、7 d较化疗前无明显变化,差异无统计学意义(P>0.05)。结论血浆中Ghrelin可能具有抑制胃癌手术后发生CINV的作用,提示胃癌手术后使用Ghrelin激动剂或类似药物可望对CINV的发生具有防治作用。

Objective:To investigate the relationship between the change of Ghrelin level and the occurrence of chemotherapy-induced nausea and vomiting(CINV)after surgery for gastric cancer.Methods:90 patients with concurrent radical gastrectomy for gastric cancer were selected and treated with FOLFOX4 chemotherapy for 2 weeks(1 cycle)at 3 weeks after surgery.Patients with nausea and vomiting after chemotherapy were set as CINV group(n=61),and patients without nausea and vomiting were set as non-CINV group(n=29).Plasma Ghrelin levels were detected by ELISA in the whole group 1 day before chemotherapy and 2,4,7 and 14 days after chemotherapy.The relationship between Ghrelin levels before and after chemotherapy and occurrence of chemotherapy-induced nausea and vomiting(CINV)in the two groups was compared and analyzed.Results:Plasma Ghrelin expression level in CINV group was significantly lower on day 2 and 4 after chemotherapy than before chemotherapy,and the difference was statistically significant(P<0.01).However,the plasma Ghrelin expression level of the non-CINV group showed no significant change on days 2,4 and 7 after chemotherapy compared with that before chemotherapy,and the difference was not statistically significant(P>0.05).Conclusion:Ghrelin in plasma may inhibit the occurrence of CINV after gastric cancer surgery,suggesting that the use of Ghrelin agonists or similar drugs is expected to have a preventive and therapeutic effect on the occurrence of CINV after surgery for gastric cancer.