西妥昔单抗联合FOLFIRI方案治疗对晚期CRC患者血清指标的影响

Effect of cetuximab combined with FOLFIRI regimen on serum indicators in patients with advanced colorectal cancer

目的探讨西妥昔单抗联合FOLFIRI方案治疗对晚期结直肠癌(CRC)患者血清基质金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制剂-1(TIMP-1)和上皮型黏附素(E-cadherin)水平的影响。方法回顾性分析2019年10月至2021年2月于四川省成都市第六人民医院救治的118例CRC患者资料,根据患者用药方案不同,分为FOLFIRI组(FOLFIRI方案,n=56)和联合组(西妥昔单抗联合FOLFIRI方案,n=62)。对比两组患者临床疗效,记录对比两组肿瘤标志物和血清相关因子水平,并分析其安全性和生存结果。结果联合组患者客观缓解率、疾病控制率均高于FOLFIRI组(P<0.05);治疗后,联合组患者肿瘤标志物[血清癌胚抗原(CEA)、糖链抗原19-9(CA19-9)]和血清相关因子[MMP-9、TIMP-1、E-cadherin]水平低于FOLFIRI组,差异均有统计学意义(P<0.05);两组患者毒副反应皮疹、腹泻等发生率差异无统计学意义(P>0.05);两组患者4、8个月的累计生存率(OS)及无进展生存率(PFS)差异无统计学意义(P>0.05),联合组12、16、24个月OS、PFS均高于FOLFIRI组,差异有统计学意义(P<0.05)。结论西妥昔单抗与FOLFIRI方案的联合治疗在对晚期CRC的疗效改善方面显现优势,可改善肿瘤标志物的表达,降低血清MMP-9、TIMP-1、E-cadherin水平,同时可改善预后,安全性良好。

Objective To investigate the effect of cetuximab combined with FOLFIRI regimen on serum levels of matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1)and epithelial adhesin(E-cadherin)in patients with advanced colorectal cancer(CRC).Methods A total of 118 CRC patients who were treated at the Sixth People’s Hospital of Chengdu,Sichuan Province from October 2019 to February 2021 were selected and divided into a FOLFIRI group(FOLFIRI regimen,n=56)and a combination group(cetuximab combined with FOLFIRI regimen,n=62)according to their different medication preferences.The clinical efficacy of two groups of patients was compared,and the levels of tumor markers,serum MMP-9,TIMP-1,and E-cadherin between the two groupswere recorded.Their safety and survival outcomes were analyzed.Results The objective response rate and disease control rate of patients in the combination group were higher than those in the FOLFIRI group(P<0.05);After treatment,the levels of tumor markers[serum carcinoembryonic antigen(CEA),glycan antigen 19-9(CA19-9)]and serum related factors[MMP-9,TIMP-1,E-cadherin]in the combination group were lower than those in the FOLFIRI group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of toxic side effects such as rash and diarrhea between the two groups of patients(P>0.05).There was no statistically significant difference in the cumulative survival rate(OS)and progression free survival rate(PFS)between the two groups of patients in 4 and 8 months(P>0.05).The combined group had higher OS and PFS in 12,16,and 24 months compared to the FOLFIRI group,and the difference was statistically significant(P<0.05).Conclusion The combination therapy of cetuximab and FOLFIRI regimen shows advantages in improving the efficacy of advanced CRC,improving the expression of tumor markers,reducing serum MMP-9,TIMP-1,E-cadherin levels,and improving prognosis with good safety.