伊立替康辅助FOLFOX化疗方案对结直肠癌患者血清肿瘤标志物及miR-200a、miR-190含量的影响

Effect of irinotecan-assisted FOLFOX chemotherapy regimen on serum levels of tumor markers,miR-200a,and miR-190 in patients with colorectal cancer

背景目前对于结直肠癌的治疗方式仍以手术为主,术后采用化疗、靶向药物治疗等药物辅助,其中靶向药受到遗传基因和价格因素的制约,化疗药物仍是治疗首选.同时已被更多的研究所证实,联合用药可以从更多途径抑制癌细胞的生长,其疗效优于单一化疗药物.目的探讨伊立替康辅助FOLFOX化疗方案在结直肠癌(colorectal cancer,CRC)中应用价值.方法选取2017-03/2019-02我院CRC患者92例,依据简单随机数字表法分为研究组(n=46)与对照组(n=46).靶向治疗基础上对照组采取FOLFOX方案,研究组在对照组基础上采取伊立替康.统计2组肿瘤控制率、血清肿瘤标志物、miR-200a、miR-190表达情况、血清转化生长因子-α(TGF-α)、胰岛素样生长因子Ⅱ(IGF-Ⅱ)水平、毒副反应发生率,随访12 mo,统计2组生存率.结果研究组肿瘤控制率(71.74%)与对照组(65.22%)间无显著差异(P>0.05);治疗后研究组血清CEA、CA125、CA199、CA72-4、TGF-α、IGF-Ⅱ水平低于对照组(P<0.05);治疗后研究组血清miR-200a、miR-190表达高于对照组(P<0.05);2组均未发生Ⅳ度毒副反应,且研究组的毒副反应发生率与对照组相比无明显差异(P>0.05);研究组治疗后6 mo、9 mo、12 mo生存率(95.56%、88.89%、80.00%)与对照组(91.11%、75.56%、64.44%)间无显著差异(P>0.05).结论联合采取FOLFOX化疗方案及伊立替康治疗CRC,可降低血清肿瘤标志物、TGF-α、IGF-Ⅱ含量,调节miR-200a、miR-190表达,且不会增加毒副反应发生风险.

BACKGROUND At present,surgery is still the main treatment for colorectal cancer,and postoperative chemotherapy and targeted drug therapy are used as auxiliary treatments.Since targeted drugs are restricted by genetic and price factors,chemotherapy drugs are still the first choice for treatment.Many studies have demonstrated that drug combination can inhibit the growth of cancer cells in more ways,and its efficacy is better than single drug chemotherapy.AIM To investigate the application value of irinotecan-assisted FOLFOX chemotherapy in colorectal cancer.METHODS A total of 92 patients with colorectal cancer treated at our hospital from March 2017 to February 2019 were selected and divided into a study group(n=46)and a control group(n=46)based on a simple random number table.On the basis of targeted therapy,the control group received the FOLFOX regimen,and the study group received irinotecan-assisted FOLFOX chemotherapy regimen.Tumor control rate,serum levels of tumor markers,miR-200a,miR-190,serum transforming growth factor-α(TGF-α),and insulin-like growth factorⅡ(IGF-Ⅱ),and the incidence of toxic and side effects were compared between the two groups.The patient were followed for 12 mo,and the survival rates of the two groups were calculated.RESULTS There was no significant difference in the tumor control rate between the study group(71.74%)and control group(65.22%;P>0.05).After treatment,serum levels of CEA,CA125,CA199,CA72-4,TGF-α,and IGF-Ⅱin the study group were significantly lower than those of the control group(P<0.05),and the expression of serum miR-200a and miR-190 in the study group was significantly higher than that of the control group(P<0.05).No grade 4 toxic and side effects occurred in either group,and there was no significant difference in the incidence of toxic and side effects between the two groups(P>0.05).There was no significant difference in survival rates at 6 mo,9 mo,and 12 mo after treatment between the study group(95.56%,88.89%,and 80.00%)and control group(91.11%,75.56%,and 64.44%;P>0.05 for all).CONCLUSION The combination of FOLFOX chemotherapy and irinotecan in the treatment of colorectal cancer can reduce the serum levels of tumor markers,TGF-α,and IGF-Ⅱ,regulate the expression of miR-200a andmiR-190,but does not increase the risk of adverse reactions.