西黄胶囊联合XP方案治疗晚期胃癌的近期疗效及对外周血肿瘤标志物、细胞免疫功能和血管生成调节因子的影响

Short-Term Efficacy of Xihuang Capsules Combined with XP Regimen in the Treatment of Advanced Gastric Cancer and Its Effects on Tumor Markers,Cellular Immune Function and Angiogenesis Regulatory Factors in Peripheral Blood

目的:探讨西黄胶囊联合卡培他滨+顺铂(XP方案)治疗晚期胃癌的近期疗效及其对患者外周血肿瘤标志物、细胞免疫功能和血管生成调节因子水平的影响。方法:选择2019年1月至2022年3月北京航天总医院收治的晚期胃癌患者152例,以随机数字表法分为观察组和对照组,每组76例。对照组患者给予XP方案治疗,观察组患者在对照组的基础上联合西黄胶囊治疗,21 d为1个疗程。连续治疗4个疗程后进行近期疗效评价,治疗过程中记录两组患者的不良反应情况。治疗前后检测两组患者血清肿瘤标志物[糖类抗原(CA)19-9、CA72-4和癌胚抗原(CEA)]、细胞免疫功能[外周血CD3^(+)、CD4^(+)、CD8^(+)T细胞百分比和CD4^(+)/CD8^(+)比值]及血清血管生成调节因子[血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)和转化生长因子-β1(TGF-β1)]水平,并随访记录两组患者的远期生存情况。结果:观察组患者的客观缓解率、疾病控制率分别为51.32%(39/76)、93.42%(71/76),显著高于对照组的30.26%(23/76)、82.89%(63/76),差异均有统计学意义(P<0.05)。观察组患者白细胞减少、血小板减少和胃肠道反应的发生率显著低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者CA19-9、CA72-4和CEA,VEGF、bFGF和TGF-β1水平均较治疗前显著降低,观察组患者较对照组降低更为显著,差异均有统计学意义(P<0.05)。治疗后,观察组患者外周血CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)比值均较治疗前显著升高,且显著高于对照组,差异均有统计学意义(P<0.05)。观察组患者中位无进展生存期、中位总生存期分别为6.1、12.9个月,均较对照组(4.7、9.8个月)显著延长,差异均有统计学意义(P<0.05)。结论:西黄胶囊联合XP方案治疗晚期胃癌患者,能有效抑制血清肿瘤标志物水平,调控血管生成调节因子的表达,改善机体细胞免疫功能,提高近期疗效及远期生存获益,且表现出一定的减毒作用。

OBJECTIVE:To probe into the short-term efficacy of Xihuang capsules combined with capecitabine+cisplatin(XP regimen) in the treatment of advanced gastric cancer and its effects on tumor markers,cellular immune function and angiogenesis regulatory factors in peripheral blood of patients.METHODS:A total of 152 patients with advanced gastric cancer admitted into Beijing Aerospace General Hospital from Jan.2019 to Mar.2022 were extracted to be divided into the observation group and control group via the random number table method,with 76 cases in each group.The control group was treated with XP regimen,while the observation group received Xihuang capsules on the basis of control group,with 21 d as a course of treatment.The short-term efficacy was evaluated after 4 consecutive courses of treatment,and the adverse reactions of two groups were recorded during the treatment.Before and after treatment,the levels of serum tumor markers [carbohydrate antigen(CA) 19-9,CA72-4,carcinoembryonic antigen(CEA)] and cellular immune function [percentage of peripheral blood CD3^(+),CD4^(+),CD8^(+) T cells,CD4^(+)/CD8^(+) ratio],serum levels of angiogenesis regulators [vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),transforming growth factor-β1(TGF-β1)] were detected in both groups.Long-term survival of two groups was followed up.RESULTS:The objective remission rate and disease control rate of observation group were respectively 51.32%(39/76) and 93.42%(71/76),significantly higher than 30.26%(23/76) and 82.89%(63/76) of control group,with statistically significant differences(P<0.05).The incidences of leukopenia,thrombocytopenia and gastrointestinal reactions in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the levels of CA19-9,CA72-4,CEA,VEGF,bFGF amd TGF-β1 in two groups decreased significantly compared with those before treatment,and the observation group was lower than the control group,with statistically significant difference(P<0.05).After treatment,the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) ratio in peripheral blood of the observation group increased significantly compared with those before treatment,and the observation group was higher than the control group,with statistically significant difference(P<0.05).The median progression-free survival and median overall survival in observation group were respectively 6.1 months and 12.9 months,significantly longer than 4.7 months and 9.8 months in the control group,with statistically significant differences(P<0.05).CONCLUSIONS:Xihuang capsules combined with XP regimen in the treatment of advanced gastric cancer can effectively inhibit the level of tumor markers,regulate the expression of angiogenesis related regulatory factors,improve the cellular immune function and short-term efficacy and long-term survival benefits,and show a certain attenuated effect.