替吉奥联合奥沙利铂治疗中晚期老年胃癌的疗效及其对血清ESM-1、IGFBP3表达的影响

Effects of Gimeracil and Oteracil Porassium Capsules Combined with Oxaliplatin in the Treatment of Advanced Gastric Cancer in the Elderly Patients and Their Effect on Serum Level of ESM-1 and IGFBP3

目的探索替吉奥联合奥沙利铂治疗中晚期老年胃癌的疗效,及其对患者血清胰岛素样生长因子结合蛋白(insulin-like growth factor binding protein-3,IGFBP3)、内皮细胞特异性分子(Endothelial cell specific molecule-1,ESM-1)水平的影响。方法选取2016年4月—2017年10月河南省人民医院收治的124例中晚期老年胃癌患者为观察对象,将其按照随机数字表法分为对照组和观察组,各62例。对照组患者采用卡培他滨与奥沙利铂治疗,观察组患者采用替吉奥与奥沙利铂治疗,观察并比较2组患者临床疗效、不良反应、生存率、肿瘤标志物水平及血清ESM-1、IGFBP3水平。结果所有治疗疗程结束后,观察组缓解率为41.94%,显著高于对照组(25.81%,χ^2=4.409,P<0.05);观察组与对照组的MMP-2、MMP-9、CA125与CEA较治疗前均显著降低(P<0.05),且观察组指标水平低于对照组(P<0.05);与治疗前相比,治疗后2组血清ESM-1水平明显降低(P<0.05),而IGFBP3水平明显升高(P<0.05),且观察组较对照组更明显(P<0.05)。不良反应方面,观察组患者发生呕吐腹泻的概率显著低于对照组(P<0.05),观察组患者24个月的生存率为51.60%,显著高于对照组(33.87%);结论替吉奥联合奥沙利铂对老年中晚期胃癌患者有较好治疗作用,可降低血清ESM-1水平,升高血清IGFBP3水平,提高患者生存期且不良反应较低。该疗法安全可靠,值得推广。

OBJECTIVE To explore the effects of Gimeracil and Oteracil Porassium Capsules combined with oxaliplatin in the treatment of advanced gastric cancer in the elderly and their effects on serum levels of endothelial cell specific molecule-1(ESM-1) and insulin-like growth factor binding protein-3(IGFBP3). METHODS From April 2016 to October 2017, 124 elderly patients with advanced gastric cancer who were treated in Henan Provincial People’s Hospital were selected as observation objects, and they were divided into control group and observation group according to the random number table method, with 62 cases each group. Patients in the control group were treated with capecitabine and oxaliplatin, while patients in the observation group were treated with Gimeracil and Oteracil Porassium Capsules and oxaliplatin. The clinical efficacy, adverse reactions survival rate, tumor marker level and serum ESM-1 and IGFBP3 levels of the two groups were observed and compared. RESULTS After all treatment courses, the remission rate of the observation group was 41.94%, which was significantly higher than that of the control group(25.81%). MMP-2, MMP-9, CA125 and CEA of the observation group and the control group were significantly lower than those before treatment(P<0.05), and the index level of the observation group was lower than that of the control group(P<0.05). Compared with before treatment, the serum ESM-1 level of 2 groups after treatment was significantly reduced(P<0.05), while IGFBP3 level was significantly increased(P<0.05), and the observation group was more obvious than the control group. As for adverse reactions, the incidence of vomiting and diarrhea in the observation group was significantly lower than that in the control group(P<0.05). The 24-month survival rates of the observation group was 51.60%, which was significantly higher than that of control group(33.87%). CONCLUSION Gimeracil and Oteracil Porassium Capsules combined with oxaliplatin has a good therapeutic effect on elderly patients with advanced gastric cancer, which can reduce the serum ESM-1 level, increase the serum IGFBP3 level, and improve the survival of patients with low adverse reactions. The therapy is safe and reliable, and worth promoting.