阿帕替尼对二线化疗失败晚期胃癌患者肿瘤标志物与胃黏膜四项水平及预后的影响

Effect of Apatinib on the Levels of Tumor Markers and Four Items of Gastric Mucosa and Prognosis in Patients with Advanced Gastric Cancer after Failure of Second-line Chemotherapy

目的:探讨阿帕替尼对二线化疗失败晚期胃癌患者肿瘤标志物与胃黏膜四项水平及预后的影响。方法:选取2016年12月2020年3月医院收治的80例二线化疗失败晚期胃癌患者,随机分为研究组和对照组各40例。对照组给予常规支持对症治疗,研究组在对照组基础上给予阿帕替尼治疗。比较两组临床疗效、肿瘤标志物[癌胚抗原(CEA)、癌抗原125(CA125)、糖蛋白抗原199(CA199)]、胃黏膜四项[胃蛋白酶原Ⅰ(PGⅠ),胃蛋白酶原Ⅱ(PGⅡ),胃泌素17(G-17)、幽门螺旋抗体(Hp-Ab)]、不良反应及预后情况。结果:研究组总缓解率、疾病控制率均高于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后研究组血清CEA、CA125、CA199水平均降低,且研究组低于对照组(P<0.05)。与治疗前比较,治疗后研究组PGⅠ水平较治疗前升高,且研究组高于对照组(P<0.05);治疗后,研究组PGⅡ、G-17水平、Hp-Ab阳性率均较治疗后降低,且研究组低于对照组(P<0.05)。两组总不良反应发生率无差异(P>0.05)。研究组无进展生存时间(PFS)、生存时间(OS)均长于对照组、生存率高于对照组,差异有统计学意义(P<0.05)。结论:阿帕替尼对二线化疗失败晚期胃癌患者的疾病控制率较好,可有效降低血清肿瘤标志物水平,改善胃粘膜功能,延长患者生存期。

Objective: To investigate the effect of apatinib on the levels of tumor markers and four items of gastric mucosa and prognosis in patients with advanced gastric cancer after failure of second-line chemotherapy. Methods: 80 patients with advanced gastric cancer who failed second-line chemotherapy in our hospital from December 2016 to March 2020 were selected and randomly divided into research group and control group, 40 cases in each group. The control group was given conventional supportive symptomatic treatment, and the research group was given apatinib on the basis of the control group. The clinical efficacy, tumor markers[carcino-embryonic antigen(CEA), cancer antigen 125(CA125), glucoprotein antigen 199(CA199)], four items of gastric mucosa [pepsinogen Ⅰ(PG Ⅰ),pepsinogen Ⅱ(PG Ⅱ), gastrin 17(G-17), Helicobacter pylori antibody(Hp-Ab)], adverse reactions and prognosis were compared between the two groups. Results: The total remission rate and disease control rate of the research group were higher than those of the control group, the difference was statistically significant(P<0.05). Compared with before treatment, the serum levels of CEA, CA125 and CA199 in the research group were decreased after treatment, and the research group was lower than the control group(P<0.05). Compared with before treatment, the level of PG Ⅰ in the study group after treatment was higher than that before treatment, and the study group was higher than that in the control group(P<0.05);after treatment, the level of PG Ⅱ, G-17 and Hp-Ab positive rate in the study group were lower than those after treatment, and the study group was lower than that in the control group(P<0.05). There was no difference in the incidence of adverse reactions between the two groups(P>0.05). The progression free survival(PFS) and overall survival time(OS) of the study group were longer than those of the control group, and the survival rate was higher than that of the control group(P<0.05).Conclusion: Apatinib has a better disease control rate in patients with advanced gastric cancer after failure of second-line chemotherapy,which can effectively reduce the level of serum tumor markers, improve gastric mucosal function and prolong the survival period of patients.