替吉奥胶囊治疗晚期消化道肿瘤的临床效果及对VEGF和MMP-9的影响

Clinical effect of tegafur capsule in the treatment of advanced gastrointestinal cancer and its influence on VEGF and MMP-9

目的研究替吉奥胶囊治疗晚期消化道肿瘤的临床效果及对血管内皮生长因子(VEGF)和基质金属蛋白酶9(MMP-9)的影响。方法100例晚期消化道肿瘤患者,均采取替吉奥胶囊治疗,观察患者治疗效果、不良反应发生情况,比较患者化疗前后VEGF和MMP-9水平及治疗效果不同患者VEGF和MMP-9水平。结果100例患者治疗有效率为57.00%,临床获益率为79.00%。主要不良反应为Ⅰ~Ⅱ级骨髓抑制、消化道反应和手足综合征。骨髓抑制表现为中性粒细胞、血红蛋白及血小板降低,其中Ⅲ级血红蛋白减少11例(11.00%),Ⅲ级中度粒细胞减少9例(9.00%),Ⅳ度粒细胞减少4例(4.00%),Ⅲ级血小板减少13例(13.00%);消化道反应表现为恶心、呕吐及口腔黏膜炎。未发生药物不良反应而造成死亡病例发生。部分缓解患者VEGF水平为(86.79±17.52)ng/L,MMP-9水平为(63.21±14.57)ng/L;稳定患者VEGF水平为(332.67±16.34)ng/L,MMP-9水平为(246.78±17.54)ng/L;进展患者VEGF水平为(485.32±14.78)ng/L,MMP-9水平为(379.45±15.32)ng/L;部分缓解患者VEGF、MMP-9水平均低于稳定、进展患者,差异有统计学意义(P<0.05);稳定患者VEGF、MMP-9水平均低于进展患者,差异有统计学意义(P<0.05)。结论对晚期消化道肿瘤患者予以替吉奥胶囊治疗,其VEGF和MMP-9水平可对预后具有一定的判断作用,对化疗起到指导作用。

Objective To study the clinical effect of tegafur capsule in the treatment of advanced gastrointestinal cancer and its influence on vascular endothelial growth factor(VEGF)and matrix metalloproteinase-9(MMP-9).Methods 100 patients with advanced gastrointestinal cancer all treated with tegafur capsule.The therapeutic effect and occurrence of adverse reactions were observed,and VEGF and MMP-9 before and after treatment,and VEGF and MMP-9 in patients with different therapeutic effects were compared.Results The effective rate of treatment for 100 patients was 57.00%,and the clinical benefit rate was 79.00%.The main adverse reactions were gradeⅠ-Ⅱbone marrow suppression,gastrointestinal reactions and hand-foot syndrome.Bone marrow suppression was manifested by decreased neutrophils,hemoglobin,and platelets.Among them,there were 11 cases(11.00%)of gradeⅢhemoglobin reduction,9 cases(9.00%)of gradeⅢmoderate neutropenia,4 cases(4.00%)of gradeⅣneutropenia,and 13 cases(13.00%)of gradeⅢthrombocytopenia;the digestive tract reactions manifested as nausea,vomiting and oral mucositis,and there was no death cases caused by adverse drug reactions.The VEGF in patients with partial remission was(86.79±17.52)ng/L,and MMP-9 was(63.21±14.57)ng/L;the VEGF of stable patients was(332.67±16.34)ng/L,and MMP-9 was(246.78±17.54)ng/L;the VEGF in progressive patients was(485.32±14.78)ng/L,and MMP-9 was(379.45±15.32)ng/L.The levels of VEGF and MMP-9 in patients with partial remission were lower than those in stable and progressive patients,and the difference was statistically significant(P<0.05);the levels of VEGF and MMP-9 in stable patients were lower than those in progressive patients,and the difference was statistically significant(P<0.05).Conclusion Patients with advanced gastrointestinal cancer are treated with tegafur capsule.The levels of VEGF and MMP-9 can be used to judge the prognosis and play a guiding role in chemotherapy.