奥拉帕尼联合GEMOX化疗方案对晚期卵巢癌血管生成和细胞凋亡的影响

Effect of olaparib combined with GEMOX chemotherapy regimen on angiogenesis and apoptosis in advanced ovarian cancer

目的观察奥拉帕尼联合GEMOX化疗方案对晚期卵巢癌的疗效,及其对血管生成和细胞凋亡的影响。方法选择2018年1月至2020年1月在该院接受治疗的96例晚期卵巢癌患者作为研究对象,根据随机数字表法将患者分为观察组和对照组,每组48例。对照组予以GEMOX方案化疗,观察组在对照组的基础上予以奥拉帕尼治疗。观察2组治疗效果、不良反应及治疗前后血清糖类抗原(CA)125、β-绒毛膜促性腺激素(β-HCG)、人附睾蛋白(HE)-4、癌胚抗原(CEA)、血管生成素(Ang)-2、血管内皮生长因子(VEGF)、血管生成素酪氨酸激酶蛋白受体(Tie)-2、巨噬细胞移动抑制因子(MIF)、程序化死亡因子(PDCD)-5、B淋巴细胞瘤基因(Bcl)-2、BCl-2相关X(Bax)和Bcl-2结合抗凋亡基因(Bag)-1水平的变化。结果观察组的客观有效率、疾病控制率为43.75%、77.08%,高于对照组的18.75%、47.92%(P<0.05)。观察组的胃肠道反应发生率为66.67%,高于对照组的41.67%(P<0.05)。2组治疗前血清CA125、β-HCG、HE-4、CEA、Ang-2、VEGF、Tie-2、MIF、Bax、PDCD-5、Bcl-2和Bag-1水平差异无统计学意义(P>0.05)。2组治疗后血清Bax、PDCD-5水平较治疗前明显升高(P<0.05),而CA125、β-HCG、HE-4、CEA、Ang-2、VEGF、Tie-2、MIF、Bcl-2和Bag-1水平较治疗前明显降低(P<0.05),且观察组升高或降低的程度较对照组更为明显(P<0.05)。结论奥拉帕尼能够提高GEMOX化疗方案治疗晚期卵巢癌的疗效,其作用机制可能与肿瘤血管生成受到抑制和细胞凋亡增加有关。

Objective To observe the efficacy of olaparib combined with GEMOX chemotherapy regimen on advanced ovarian cancer and its effect on angiogenesis and apoptosis.Methods A total of 96 patients with advanced ovarian cancer who were treated in the hospital from January 2018 to January 2020 were selected as research objects.According to the random number table method,they were divided into observation group and control group,with 48 cases in each group.The control group was treated with GEMOX chemotherapy,and the observation group was treated with olaparib on the basis of the control group.The therapeutic effects,adverse reactions and the changes of serum carbohydrate antigen(CA)125,β-Chorionic gonadotropin(β-HCG),human epididymal protein(He)-4,carcinoembryonic antigen(CEA),angiopoietin(Ang)-2,vascular endothelial growth factor(VEGF),angiopoietin tyrosine kinase protein receptor(TIE)-2,macrophage migration inhibitory factor(MIF),programmed death factor(PDCD)-5,B lymphocytoma gene(BCL)-2,BCL-2 related X(Bax)and Bcl-2 binding anti apoptotic gene(Bag)-1 levels before and after treatment were observed.Results The objective effective rate and disease control rate of the observation group were 43.75%and 77.08%,which were higher than 18.75%and 47.92%of the control group(P<0.05).The incidence of gastrointestinal reactions in the observation group was 66.67%,which was higher than 41.67%in the control group(P<0.05).There was no significant difference in the levels of serum CA125,β-HCG,HE-4,CEA,Ang-2,VEGF,Tie-2,MIF,Bax,PDCD-5,Bcl-2 and Bag-1 between the two groups before treatment(P>0.05).The levels of serum Bax and PDCD-5 levels in the two groups were significantly higher than those before treatment(P<0.05),while CA125,β-HCG,HE-4,CEA,Ang-2,VEGF,Tie-2,MIF,Bcl-2 and Bag-1 were significantly lower than those before treatment(P<0.05),and the degree of increase or decrease in the observation group was more significant than that of the control group(P<0.05).Conclusion Olaparib can improve the efficacy of GEMOX chemotherapy regimen in the treatment of advanced ovarian cancer,and its mechanism of action may be related to the inhibition of tumor angiogenesis and the increase of cell apoptosis.