曲妥珠单抗对晚期胃癌患者血清环氧合酶2、核因子-κB表达的影响

The effect of trastuzumab on the expression of cyclooxygenase 2 and nuclear factor-κB in patients with advanced gastric cancer

目的探讨曲妥珠单抗治疗晚期胃癌的临床效果及对血清环氧合酶2(COX2)、核因子-κB(NF-κB)的影响。方法依据治疗方案将98例晚期胃癌患者分为观察组(n=50)和对照组(n=48),对照组患者接受顺铂+卡培他滨治疗,观察组患者在此基础上联合曲妥珠单抗治疗。比较两组患者的近远期疗效,血清COX2、NF-κB水平和不良反应发生情况。结果观察组患者的临床疗效优于对照组患者,治疗总有效率为66.00%,高于对照组患者的31.25%,差异均有统计学意义(P﹤0.05)。治疗后1个月,两组患者血清COX2水平均低于本组治疗前,NF-κB水平均高于本组治疗前,且观察组患者血清COX2水平低于对照组,NF-κB水平高于对照组患者,差异均有统计学意义(P﹤0.05)。观察组患者的中位无进展生存时间为8.00个月(95%CI:7.30~8.70个月),长于对照组患者的5.00个月(95%CI:4.24~5.76个月),中位总生存时间为13.00个月(95%CI:12.45~13.55个月),长于对照组患者的9.00个月(95%CI:8.44~9.56个月),差异均有统计学意义(P﹤0.05)。两组患者3~4级恶心呕吐、肝功能损害、骨髓抑制和手足综合征不良反应发生率比较,差异均无统计学意义(P﹥0.05)。结论曲妥珠单抗治疗晚期胃癌的效果较好,可明显改善血清肿瘤标志物水平,且不增加不良反应。

Objective To investigate the clinical effect of trastuzumab in the treatment of advanced gastric cancer and its effect on serum cyclooxygenase 2(COX2)and nuclear factorκB(NF-κB).Method According to the treatment plan,98 patients with advanced gastric cancer were divided into observation group(n=50)and control group(n=48).The control group was treated with cisplatin and capecitabine,and patients in the observation group were treated with trastuzumab on this basis.The short-term and long-term efficacy,serum COX2,NF-κB levels and adverse reactions were compared between the two groups.Result The clinical efficacy of the observation group was better than that of the control group,the total effective rate was 66.00%,higher than 31.25%of the control group,the differences were statistically significant(P<0.05);One month after treatment,the serum COX2 level of the two groups was lower than that before the treatment,and the NF-κB level was higher than that before the treatment,and the serum COX2 level of the observation group was lower than that of the control group,and the NF-κB level was higher than that of the control group,the differences were statistically significant(P<0.05).The median progression free survival time of the observation group was 8.00 months(95%CI:7.30-8.70 months),which was longer than that of the control group 5.00 months(95%CI:4.24-5.76 months),the median total survival time was 13.00 months(95%CI:12.45-13.55 months),and which was longer than that of the control group 9.00 months(95%CI:8.44-9.56 months),the differences were statistically significant(P<0.05).There was no significant difference in the incidence of grade 3-4 nausea and vomiting,liver function damage,bone marrow suppression and hand-foot syndrome between the two groups(P>0.05).Conclusion Trastuzumab is effective in the treatment of advanced gastric cancer.It can significantly improve the level of serum tumor markers and without increasing adverse reactions.