辅助化疗联合靶向治疗应用于人表皮生长因子受体-2阳性胃癌患者中的疗效

Efficacy of Adjuvant Chemotherapy combined with Targeted Therapy in Human Epidermal Growth Factor Receptor-2 Positive Gastric Cancer Patients

目的探讨辅助化疗联合靶向治疗应用于人表皮生长因子受体-2(HER-2)阳性胃癌患者中的疗效。方法选取2020年7月至2022年7月于伊犁哈萨克自治州奎屯医院治疗的HER-2阳性胃癌患者65例作为研究对象,根据用药方法不同分为常规组32例和联合组33例。常规组予以卡培他滨联合奥沙利铂治疗,联合组在常规组基础上采用注射用曲妥珠单抗治疗。比较两组患者临床疗效;不良反应发生率[血红蛋白下降、恶心呕吐、肾毒性、白细胞下降、血小板下降、胃毒性];胃癌标志物水平[糖类抗原199(CA199)、癌抗原724(CA724)、癌胚抗原(CEA)];血清血管内皮生长因子(VEGF)水平[VEGF-A、VEGF-D、VEGF-1];T细胞亚群水平[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)];生命质量评分[社会关系、生理功能、精神状态、认知水平];生存率[治疗后1年、3年、5年]。结果联合组治疗有效率显著优于常规组(P<0.05);治疗后两组患者不良反应发生率比较差异无统计学意义(P>0.05);治疗后联合组CA199、CA724、CEA水平显著低于常规组(P<0.05);治疗后,联合组血清VEGF-A、VEGF-D、VEGF-1水平显著优于常规组(P<0.05);治疗后,联合组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平显著高于常规组(P<0.05);联合组社会关系、生理功能、精神状态、认知水平评分显著高于常规组(P<0.05);治疗后3年与5年,联合组生存率显著高于常规组(P<0.05)。结论给予HER-2阳性胃癌患者辅助化疗联合靶向治疗临床效果显著,可有效降低患者胃癌标志物水平,改善血清VEGF以及T细胞亚群水平,提高生命质量与远期生存率,不良反应发生率较低。

Objective To explore the efficacy of adjuvant chemotherapy combined with targeted therapy in human epidermal growth factor receptor-2(HER-2)positive gastric cancer patients.Methods Sixty-five patients with HER-2 positive gastric cancer treated in Kuitun Hospital of Yili Kazak Autonomous Prefecture from July 2020 to July 2022 were selected as the study objects,and were divided into the conventional group(32 cases)and the combined group(33 cases)according to different medication methods.The conventional group was treated with capecitabine combined with oxaliplatin,and the combined group was treated with trastuzumab for injection on the basis of the conventional group.The clinical efficacy;Incidence of adverse reactions[decreased hemoglobin,nausea and vomiting,nephrotoxicity,leukopenia,thrombocytopenia,gastrotoxicity];Gastric cancer marker levels[carbohydrate antigen 199(CA199),cancer antigen 724(CA724),carcinoembryonic antigen(CEA)];Serum vascular endothelial growth factor(VEGF)levels[VEGF-A,VEGF-D,VEGF-1];T cell subsets[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)];Quality of life score[social relations,physiological function,mental state,cognitive level];Survival rate[1,3,5 years after treatment]of the two groups were compared.Results The effective rate of combined group was significantly better than that of conventional group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups after treatment(P>0.05).After treatment,the levels of CA199,CA724 and CEA in combination group were significantly lower than those in conventional group(P<0.05).After treatment,the serum levels of VEGF-A,VEGF-D and VEGF-1 in combination group were significantly higher than those in conventional group(P<0.05).Afer treatment,the levels of CD3^(+)、CD4^(+)and CD4^(+)/CD8^(+)in combination group were significantly higher than those in conventional group(P<0.05).The scores of social relationship,physiological function,mental state and cognitive level in the combined group were significantly higher than those in the conventional group(P<0.05).At 3 and 5 years after treatment,the survival rate of combined group was significantly higher than that of conventional group(P<0.05).Conclusion Adjuvant chemotherapy combined with targeted therapy in patients with HER-2 positive gastric cancer has significant clinical effect,which can effectively reduce the level of gastric cancer markers in patients,improve the level of serum VEGF and T cell subsets,improve the quality of life and long-term survival rate,and the incidence of adverse reactions is low.