全程新辅助治疗局部进展期中低位直肠癌的疗效及对恶性生物学标志基因表达的影响

Effect of Whole Course Neoadjuvant Therapy on Efficacy of Locally Advanced Middle and Low Rectal Cancer and Expression of Malignant Biological Marker Genes in the Lesion

【目的】探讨全程新辅助治疗局部进展期中低位直肠癌的疗效及对病灶内恶性生物学标志基因表达的影响。【方法】本院收治的74例局部进展期中低位直肠癌患者随机分为对照组和观察组,每组37例。对照组术前进行新辅助治疗,观察组术前进行全程新辅助治疗。比较两组近期抗肿瘤疗效、病灶切除情况,统计两组病灶内生物学标志基因表达情况、药物安全性及预后情况。【结果】观察组客观缓解率高于对照组(P<0.05)。观察组R0切除率高于对照组(P<0.05)。两组手术切除病灶的基质金属蛋白酶-11(MMP-11)、Slug相对表达量均低于治疗前(P<0.05),且观察组均低于对照组(P<0.05)。两组手术切除病灶的微管相关肿瘤抑制基因1(MTUS1)、基质金属蛋白酶组织抑制因子1(TIMP1)、Runx3、p53相对表达量均高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。两组手足综合征、恶心、呕吐、腹泻、周围神经病变发生率比较,差异均无统计学意义(P>0.05)。观察组3年存活率高于对照组,且两组患者总存活率曲线比较,差异有统计学意义(P<0.05)。【结论】全程新辅助治疗可提高局部进展期中低位直肠癌患者近期疗效及手术R0切除率,抑制癌细胞侵袭,改善患者预后。

【Objective】To analyze the effect of whole course neoadjuvant therapy on the curative effect of locally advanced middle and low rectal cancer and the expression of malignant biological marker genes in the lesions.【Methods】A total of 74 patients with locally advanced middle and low rectal cancer who were admitted to our hospital were selected as the research subjects.They were randomly divided into the control group and the observation group,with 37 cases in each group.The control group was given neoadjuvant therapy before surgery,while the observation group was given whole course neoadjuvant therapy.The recent anti-tumor efficacy and lesion resection were compared between the two groups.The expression of biological marker genes in the lesions,drug safety and the prognosis of the two groups were counted as well.【Results】The objective remission rate of the observation group was higher than that of the control group(P<0.05).The R0 resection rate in the observation group was higher than that in the control group(P<0.05).The relative expression levels of matrix metalloproteinase-11(MMP-11)and Slug in the surgically removed lesions of the two groups were lower than before treatment(P<0.05).The relative expression levels of MMP-11 and Slug in the observation group were lower than those in the control group(P<0.05).The relative expressions of microtubule-related tumor suppressor genes 1(MTUS1),matrix metalloproteinase 1(TIMP1),Runx3,and p53 in surgically removed lesions were higher than before treatment in the two groups(P<0.05);And their relative expression levels in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of hand-foot syndrome,nausea and vomiting,diarrhea,and peripheral neuropathy between the two groups(P>0.05).The three-year survival rates of the observation group was higher than that of the control group.The overall survival rate curves of the two groups were compared,and the difference between the two groups was statistically significant(P<0.05).【Conclusion】The whole course neoadjuvant therapy can improve the short-term curative effect and surgical R0 resection rate in patients with locally advanced middle and low rectal cancer,inhibit cancer cell invasion,and improve the prognosis.