两种二线化疗方案对晚期胃癌患者肿瘤标志物及免疫功能的影响

Effects of Two Second-line Chemotherapy Regimens on Tumor Markers and Immune Function in Patients with Advanced Gastric Cancer

目的:分析两种不同的二线化疗方案对晚期胃癌患者肿瘤标志物及免疫功能的影响。方法:选取山东第一医科大学第一附属医院2021年1月—2022年11月收治的二线治疗胃癌晚期患者126例,按照随机数字抽取法分为控制组和试验组,各63例,控制组给予多西他赛结合治疗,试验组在前者的基础上联合阿帕替尼治疗,比较两组临床治疗效果、肿瘤标志物[糖类抗原125(CA125)、糖类抗原724(CA724)、癌胚抗原(CEA)]水平、免疫功能、不良反应发生情况。结果:试验组疾病控制率为79.37%,控制组为60.32%,差异有统计学意义(P<0.05);试验组治疗后辅助性T细胞1(Th1)、Th1/辅助性T细胞2(Th2)明显高于控制组,Th2低于控制组,差异均有统计学意义(P<0.05);两组治疗后的CA724、CA125、CEA水平均低于本组治疗前,且试验组均低于控制组,差异均有统计学意义(P<0.05);试验组不良反应总发生率(9.52%)低于控制组(25.40%),差异有统计学意义(P<0.05)。结论:多西他赛联合阿帕替尼二线治疗晚期胃癌患者临床效果良好,可有效改善患者的免疫功能,降低CA724、CEA、CA125水平,减少不良反应发生,安全性较高。

Objective:To analyze the effects of two different second-line chemotherapy regimens on tumor markers and immune function in patients with advanced gastric cancer.Method:A total of 126 patients with advanced gastric cancer admitted to the First Affiliated Hospital of Shandong First Medical University from January 2021 to November 2022 were randomly divided into the control group and the experimental group,with 63 patients in each group.The control group was given Docetaxel combined treatment,while the experimental group was treated with Apatinib on the basis of the former.The clinical therapeutic effect,the level of tumor markers[carbohydrate antigen 125(CA125),carbohydrate antigen 724(CA724),carcinoembryonic antigen(CEA)],immune function and occurrence of adverse reactions were compared between the two groups.Result:The disease control rate was 79.37%in the experimental group and 60.32%in the control group,the difference was statistically significant(P<0.05).After treatment,Th1 and Th1/Th2 in the experimental group were significantly higher than those in the control group,while Th2 was lower than that in control group,the differences were statistically significant(P<0.05).The levels of CA724,CA125 and CEA in two groups after treatment were lower than before,and the experimental group were lower than the control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the experimental group(9.52%)was lower than that in the control group(25.40%),the difference was statistically significant(P<0.05).Conclusion:Docetaxel combined with Apatinib in the second-line treatment of advanced gastric cancer patients has good clinical effect,can effectively improve the immune function of patients,reduce CA724,CEA,CA125 levels,reduce the occurrence of adverse reactions,with high safety.