脾多肽注射液联合替吉奥+顺铂方案治疗晚期胃癌的效果及对外周血γ干扰素/白细胞介素4比值、T淋巴细胞亚群水平的影响

Therapeutic efficacy of Lienal Polypeptide Injection combined with tegafur,gimeracil and oteracil potassium plus cisplatin regimen for advanced gastric cancer and its effects on interferon-γto interleukin 4 ratio and T lymphocyte subsets levels in peripheral blood

目的探讨脾多肽注射液联合替吉奥^(+)顺铂(SP)方案治疗晚期胃癌的临床效果以及对外周血γ干扰素(IFN-γ)/白细胞介素(IL)-4比值、T淋巴细胞亚群水平的影响。方法将80例晚期胃癌患者随机分成观察组和对照组,各40例。对照组给予SP方案化疗,观察组给予SP方案化疗联合脾多肽注射液治疗,连续治疗3个周期后评估两组疗效。比较两组临床疗效、治疗前后的血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原(CA)72-4、CA199]水平,外周血IFN-γ/IL-4比值、T淋巴细胞亚群(CD3^(+)T淋巴细胞、CD4^(+)/CD8^(+)比值)水平,以及卡氏功能状态量表(KPS)评分改善情况,并记录两组患者治疗期间的毒副反应。结果治疗后两组客观缓解率差异无统计学意义(P>0.05),但观察组的临床获益率高于对照组(P<0.05);两组患者的血清CEA、CA72-4和CA199水平均低于治疗前,且观察组低于对照组(均P<0.05);观察组KPS评分改善情况优于对照组(均P<0.05);观察组外周血IFN-γ/IL-4比值、CD4^(+)/CD8^(+)比值及CD3^(+)T淋巴细胞水平均高于治疗前且高于对照组(P<0.05),而对照组治疗前后差异无统计学意义(P>0.05)。两组患者耐受性均较好,均未出现治疗相关死亡,观察组1~2级贫血、中性粒细胞减少的发生率均低于对照组(均P<0.05)。结论与单纯SP方案化疗相比,脾多肽注射液联合SP方案治疗晚期胃癌的效果更佳,且能更有效地改善患者的健康状况,促进机体细胞免疫防御系统的重建,同时减轻SP方案化疗所致的血液学毒性反应。

Objective To investigate the clinical efficacy of Lienal Polypeptide Injection combined with tegafuR,gimeracil and oteracil potassium plus cisplatin(SP)regimen foRthe treatment of advanced gastric canceRas well as its effects on the ratio of interferon-γ(IFN-γ)to interleukin(IL)-4 and the levels of T lymphocyte subsets in peripheral blood.Methods Eighty patients with advanced gastric canceRwere randomly divided into observation group(n=40)and control group(n=40).The control group was given chemotherapy with SP regimen,and the observation group was given chemotherapy with SP regimen combined with Lienal Polypeptide Injection.AfteRconsecutive treatment foRthree cycles,efficacy assessment was performed in the two groups.The related indices were compared between the two groups,including clinical efficacy,pre-and post-treatment serum tumoRmarkers(carcinoembryonic antigen[CEA],carbohydrate antigen[CA]72-4,and CA199)levels,peripheral blood ratio of IFN-γto IL-4,and T lymphocyte subsets(CD3^(+)T lymphocyte and ratio of CD4^(+)to CD8^(+))levels,as well as improvements in the Karnofsky Performance Status Scale(KPS)scores,and the toxic and side effects during treatment were recorded in both groups.Results AfteRtreatment,there was no statistically significant difference in objective remission rate between the two groups(P>0.05),but the observation group yielded a higheRclinical benefit rate than the control group(P<0.05);serum CEA,CA72-4 and CA199 levels were decreased in both groups as compared with those before treatment,and the observation group had loweRlevels than the control group(all P<0.05);the observation group was superioRto the control group in improvements in KPS scores(all P<0.05);the ratio of IFN-γto IL-4,ratio of CD4^(+)to CD8^(+),and CD3^(+)T lymphocyte level in peripheral blood in the observation group were higheRthan those before treatment oRin the control group(P<0.05),whereas pre-and post-treatment indices in the control group showed no statistically significant difference(P>0.05).In the two groups,patients exhibited a favorable tolerance,and no treatment-related death occurred.The incidence rates of grade 1 to 2 anemia and neutropenia in the observation group were loweRthan those in the control group(all P<0.05).Conclusion Compared with chemotherapy with simple SP regimen,Lienal Polypeptide Injection combined with SP regimen has betteRtherapeutic efficacy foRadvanced gastric cancer,and it can improve patients′health status more effectively,promote somatic cellulaRimmune defense system reconstruction,and reduce hematological toxic reactions caused by chemotherapy with SP regimen.