腹腔镜下CA724表达与新辅助化疗在进展期胃癌中的应用

Application of CA724 expression under laparoscopy and neoadjuvant chemotherapy in advanced gastric cancer

目的:探索CA724表达与新辅助化疗结合腹腔镜D2根治术治疗进展期胃癌疗效及预后的相关性。方法:回顾性分析我院2017年1月-2018年1月期间收治的局部进展期胃癌患者68例临床资料,根据治疗方案的不同分为对照组30例、研究组38例,对照组采取单纯腹腔镜D2根治术治疗,研究组在腹腔镜D2根治术的基础上结合新辅助化疗治疗,对比两组总有效率、预后情况、CA724表达水平以及阳性率差异,采用Spearman相关性分析法检验CA724水平与患者疗效及预后的关系。结果:研究组患者的总有效率(60.53%)高于对照组患者(43.33%),但差异无统计学意义(χ^(2)=1.989,P=0.158);研究组患者的3年生存率(78.95%)明显高于对照组患者(56.67%),复发转移率(18.42%)则明显低于对照组患者(46.67%),差异有统计学意义(χ^(2)=3.899、6.266,P=0.048、0.012);两组患者术后的CA724表达水平和阳性率均较本组治疗前明显下降,且研究组的下降幅度大于对照组(χ^(2)/t=5.643、6.546,P<0.001);CA724的表达平与患者的疗效及三年生存率呈负相关(r=-0.625、-0.732和-0.832、-0.839,P均<0.001),与患者的复发、转移率呈正相关(r=0.662和0.873,P均<0.001)。结论:血清CA724的表达水平及阳性率变化可在一定程度上反映行新辅助化疗结合腹腔镜D2根治术治疗进展期胃癌患者的疗效及预后情况,当CA724的表达水平及阳性率较低时,提示患者的疗效及预后情况较好,具有一定的临床意义。

Objective:To explore the correlation between CA724 expression and neoadjuvant chemotherapy combined with laparoscopic D2 radical surgery for the treatment of advanced gastric cancer.Methods:A retrospective analysis of the clinical data of 68 patients with locally advanced gastric cancer admitted to our hospital from January 2017 to January 2018.According to the different treatment options,they were divided into a control group of 30 cases and a study group of 38 cases.Laparoscopic D2 radical resection,the research group combined with neoadjuvant chemotherapy on the basis of laparoscopic D2 radical resection.The total effective rate,prognosis,CA724 expression level and positive rate of the two groups were compared,and the Spearman correlation analysis method was used to test CA724.The relationship between level and patient efficacy and prognosis.Results:The total effective rate(60.53%)of the study group was higher than that of the control group(43.33%),but the difference was not statistically significant(χ^(2)=1.989,P=0.158);the 3-year survival rate of the study group(78.95%),was significantly higher than the control group(56.67%),the recurrence and metastasis rate(18.42%)was significantly lower than the control group(46.67%),the difference was statistically significant(χ^(2)=3.899,6.266,P=0.048,0.012);The expression level and positive rate of CA724 in the two groups of patients were significantly lower than those before treatment in this group,and the decline in the study group was greater than that in the control group(χ^(2)/t=5.643,6.546,P<0.001);the expression of CA724 was the same as that of the patients The curative effect and three-year survival rate were negatively correlated(r=-0.625,-0.732 and-0.832,-0.839,all P<0.001),and positively correlated with the patient's recurrence and metastasis rate(r=0.662 and 0.873,all P<0.001).Conclusion:The change of serum CA724 expression level and positive rate can reflect the efficacy and prognosis of neoadjuvant chemotherapy combined with laparoscopic D2 radical surgery for advanced gastric cancer to some extent.When the expression level and positive rate of CA724 decrease,It indicates that the patient's curative effect and prognosis are good and have certain clinical significance.