多西他赛联合奥沙利铂及替吉奥对晚期胃癌患者肿瘤标志物及血清VEGF与IGF-1的影响

Effects of docetaxel combined with oxaliplatin and tegio on tumor markers and serum VEGF and IGF-1 in patients with advanced gastric cancer

目的探究多西他赛联合奥沙利铂及替吉奥对晚期胃癌患者肿瘤标志物[糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)、癌胚抗原(CEA)]、血清血管内皮生长因子(VEGF)、胰岛素样生长因子(IGF-1)及基质金属蛋白酶(MMP)的影响。方法选择2020年1月—2021年12月于本院就诊的72例晚期胃癌患者为临床观察对象,按随机数字表法分为2组,各36例。对照组患者行奥沙利铂联合替吉奥方案化疗,研究组行多西他赛联合奥沙利铂及替吉奥的新辅助化疗,每间隔3周再次给药,共给药治疗3次。比较2组近期疗效、血清肿瘤标志物、血管新生因子、细胞侵袭分子水平变化及不良反应发生率。结果研究组近期治疗总有效率为77.78%,高于对照组的52.78%(χ^(2)=4.963,P=0.026);治疗后,研究组血清CA19-9、CA72-4、CEA、VEGF、IGF-1、MMP-2、MMP-9分别为(16.40±3.34)U/mL、(17.52±3.18)U/mL、(6.13±1.65)μg/L、(135.94±17.85)ng/L、(216.31±28.93)μg/L、(60.56±8.71)ng/mL、(197.72±68.11)ng/mL,低于对照组的(28.93±3.85)U/mL、(29.75±4.17)U/mL、(12.79±2.54)μg/L、(203.81±21.57)ng/L、(302.59±35.97)μg/L、(83.14±10.32)ng/mL、(290.64±82.13)ng/mL(t=14.750、13.993、13.193、14.545、11.215、10.032、5.225,P均<0.001);2组化疗期间不良反应发生率差异无统计学意义(χ^(2)=0.355,P=0.552)。结论多西他赛联合奥沙利铂及替吉奥在晚期胃癌中治疗效果较为确切,能促使肿瘤病灶缩小,降低血清肿瘤标志物表达水平,有效抑制血管新生因子、细胞侵袭分子释放,控制疾病进展,且不良反应较少,安全性较高,可于临床推广。

Objective To investigate the effects of docetaxel combined with oxaliplatin and tegio on tumor markers[carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 72-4(CA72-4),carcinoembryonic antigen(CEA)],serum vascular endothelial growth factor(VEGF),insulin-like growth factor(IGF-1)and matrix metalloproteinases(MMP)in patients with advanced gastric cancer.Methods A total of 72 patients with advanced gastric cancer who were treated in our hospital from January 2020 to December 2021 were selected as clinical observation objects and were divided into 2 groups with 36cases in each group according to the random number table method.The control group patients received oxaliplatin combined with tegio chemotherapy,and the trial group patients received docetaxel combined with oxaliplatin and tegio neoadjuvant chemotherapy and re-administered every 3 weeks for a total of 3 times.The short-term efficacy,serum tumor markers,angiogenic factors,changes of cell invasion molecular level,and incidence of adverse reactions were compared between the two groups.Results The total effective rate of short-term treatment in the trial group was 77.78%,which was higher than that(52.78%)of the control group(χ^(2)=4.963,P=0.026).After treatment,in the trial group,serum CA19-9,CA72-4,CEA,VEGF,IGF-1,MMP-2,and MMP-9 were(16.40±3.34)U/mL,(17.52±3.18)U/mL,(6.13±1.65)μg/L,(135.94±17.85)ng/L,(216.31±28.93)μg/L,(60.56±8.71)ng/mL,and(197.72±68.11)ng/mL,which were lower than those in the control group:(28.93±3.85)U/mL,(29.75±4.17)U/mL,(12.79±2.54)μg/L,(203.81±21.57)ng/L,(302.59±35.97)μg/L,(83.14±10.32)ng/mL,and(290.64±82.13)ng/m L respectively(t=14.750,13.993,13.193,14.545,11.215,10.032,5.225,all P<0.001).There was no significant difference in the incidence of adverse reactions during chemotherapy between the two groups(χ^(2)=0.355,P=0.552).Conclusion Docetaxel combined with oxaliplatin and tegio has a more accurate therapeutic effect in advanced gastric cancer,which can promote tumor lesion shrinkage,reduce the expression level of serum tumor markers,effectively inhibit the release of angiogenesis factors and cell invasion molecules,control disease progression,and have fewer adverse reactions and high safety,which can be promoted clinically.