阿帕替尼治疗晚期胃癌对肠道微生态和外周血肿瘤异常蛋白水平的影响

Effects of apatinib on intestinal microecology and tumor abnormal protein level in peripheral blood in patients with advanced gastric cancer

目的探讨阿帕替尼治疗晚期胃癌对肠道微生态和外周血肿瘤异常蛋白(TAP)水平的影响。方法选取2019年5月至2020年5月间长武县人民医院收治的96例胃癌患者为研究对象。根据治疗方法不同进行分组,其中采用常规多西他赛和替吉奥化疗的48例患者纳入对照组,采用常规多西他赛和替吉奥基础上联合阿帕替尼治疗的48例患者纳入观察组。在治疗前后检查两组患者大肠埃希菌、粪肠球菌、双歧杆菌、乳酸杆菌、TAP、T淋巴细胞亚群CD4^(+)、CD3^(+)、CD8^(+)、糖类抗原19-9(CA19-9)、肿瘤特异性生长因子(TSGF)和癌胚抗原(CEA)水平,比较两组患者不良反应情况。结果治疗前,两组患者的大肠埃希菌、粪肠球菌、双歧杆菌和乳酸杆菌水平比较,差异无统计学意义(P>0.05)。治疗后,两组患者的大肠埃希菌水平升高,且观察组大肠埃希菌水平高于对照组,差异均有统计学意义(均P<0.05)。两组患者的粪肠球菌、双歧杆菌和乳酸杆菌水平均降低,且观察组粪肠球菌、双歧杆菌和乳酸杆菌均低于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组患者的CD3^(+)、CD8^(+)、CD4^(+)和TAP水平比较,差异无统计学意义(P>0.05)。治疗后,两组患者的CD3^(+)、CD8^(+)和CD4^(+)水平升高,且观察组的CD3^(+)、CD8^(+)和CD4^(+)水平均高于对照组,差异均有统计学意义(均P<0.05)。两组患者的TAP水平降低,观察组TAP水平低于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组患者的CEA、CA19-9和TSGF水平比较,差异无统计学意义(P>0.05)。治疗后,两组患者的CEA、CA19-9和TSGF水平降低,且观察组CEA、CA19-9和TSGF水平低于对照组,差异均有统计学意义(均P<0.05)。观察组不良反应发生率为4.2%,低于对照组的16.7%,差异有统计学意义(P<0.05)。结论阿帕替尼治疗晚期胃癌患者,可稳定患者肠道微生态,降低患者的TAP、CEA、CA19-9和TSGF水平,改善患者免疫功能,降低患者不良反应。

Objective To observe the effects of apatinib on intestinal microecology and the level of tumor abnormal protein(TAP)in peripheral blood in patients with advanced gastric cancer.Methods Ninety-six patients with gastric cancer who were admitted to Changwu County People’s Hospital from May 2019 to May 2020 were selected as the research subjects.They were randomly divided into an observation group and a control group based on the therapies they received.Forty-eight patients receiving apatinib plus docetaxel and tegafur were included in an observation group and 48 patients receiving docetaxel and tegafur were included in a control group.The levels of Escherichia coli,Enterococcus faecalis,Bifidobacterium,Lactobacillus,TAP,T lymphocyte subsets CD4+,CD3+,CD8+,carbohydrate antigen 19-9(CA19-9),tumor specific growth factor(TSGF)and carcinoembryonic antigen(CEA)were detected before and after treatment and the adverse reactions were compared between the two groups.Results There was no significant difference in the levels of Escherichia coli,Enterococcus faecalis,Bifidobacterium and Lactobacillus between the two groups before the treatment(all P<0.05).After the treatment,the levels of Escherichia coli increased in both groups with the observation group higher than the control group(all P<0.05).The levels of Enterococcus faecalis,Bifidobacterium and Lactobacillus decreased in both groups with the observation group lower than the control group(all P<0.05).There was no significant difference in the levels of CD4+,CD3+and CD8+between the two groups before the treatment(P>0.05).After the treatment,the levels of CD4+,CD3+and CD8+increased in both groups with the observation higher than the control groups(all P<0.05).There was no significant difference in the levels of CEA,CA19-9 and TSGF between the two groups before the treatment(P>0.05).After the treatment,the levels of CEA,CA19-9 and TSGF decreased in both groups with the observation lower than the control groups(all P<0.05).The incidence of adverse reactions was 4.2%in the study group which was lower than 16.7%of the control group(P<0.05).Conclusion In the treatment of patients with advanced gastric cancer,apatinib can stabilize the intestinal microecology,reduce the levels of TAP,CEA,CA19-9 and TSGF,improve the immune function and reduce the adverse reactions.