氟尿嘧啶腹腔化疗联合淋巴结清扫术治疗进展期胃癌的疗效分析及对HIF-1α、VEGF的影响

Analysis of Curative Effect of Fluorouracil Intraperitoneal Chemotherapy Combined with Lymph Node Dissection in the Treatment of Advanced Gastric Cancer and Its Influence on HIF-1 and VEGF

目的 :探讨氟尿嘧啶腹腔化疗联合淋巴结清扫术对进展期胃癌的治疗效果及对低氧诱导因子1α(HIF-1α)、血管内皮生长因子(VEGF)的影响。方法:回顾性分析2015年3月-2016年12月我院收治的80例进展期胃癌(UGC)患者的临床资料,根据其治疗方式不同分为对照组和观察组,各40例。对照组给予常规手术清扫淋巴结,观察组在常规手术治疗基础上给予氟尿嘧啶(300 mg,分3次口服)腹腔化疗。观察两组患者术后1年生存率,比较两组患者治疗前后肿瘤标志物水平、HIF-1α和VEGF阳性表达、不良反应发生率和生活质量的差异。结果 :观察组术后1年生存率明显高于对照组(P<0.05);两组治疗前肿瘤标志物水平无统计学差异(P>0.05),治疗后3个月,观察组癌胚抗原(CEA)、糖链抗原15-3(CA15-3)和糖类抗原125(CA125)水平低于对照组(P<0.05);两组治疗前HIF-1α和VEGF阳性表达率无统计学差异(P>0.05),治疗后3个月,观察组HIF-1α和VEGF阳性表达率低于对照组(P<0.05);两组治疗前生活质量无统计学差异(P>0.05),治疗后3个月,观察组生活质量明显高于对照组(P<0.05);两组恶心呕吐、骨髓抑制、胃肠道反应和肝肾功能异常发生率无统计学差异(P>0.05)。结论 :氟尿嘧啶腹腔化疗联合淋巴结清扫术对进展期胃癌患者有较好的治疗效果,可明显提高患者生存率和生活质量,具有良好的应用价值。

Objective:To investigate the therapeutic effect of 5-fluorouracil intraperitoneal chemotherapy combined with lymph node dissection in the treatment of advanced gastric cancer and the effect on hypoxia inducible factor 1α(HIF-1α) and vascular endothelial growth factor(VEGF). Methods:The clinical data of patients with advanced gastric cancer(UGC) admitted in Affiliated Tumor Hospital of Zhengzhou University from March 2015 to December 2016 was retrospectively analyzed. The patients were divided into control group and observation group according to their treatment methods, with 40 cases in each group. Patients in control group were treated with routine lymph node dissection surgery, while patients in the observation group were additionally treated with fluorouracil intraperitoneal chemotherapy(300 mg, took it 3 times) on the basis of routine surgery treatment. 1 year survival rate of the patients in the two groups was observed, and the levels of tumor markers, positive expressions of HIF-1α and VEGF, incidence of adverse reactions and quality of life were compared between the two groups before and after treatment. Results:The 1 year survival rate of the observation group post treatment was significantly higher than that in the control group. The tumor markers level of patients in the two groups showed no significant difference before treatment, after 3 months of treatment, the expression of carcinoembryonic antigen(CEA), sugar chain antigen 15-3(CA15-3) and carbohydrate antigen 125(CA125) of patients in the observation group was significantly lower than that in the control group(P<0.05). There was no difference between the positive expression of HIF-1α and VEGF of two groups of patients before treatment, after 3 months of treatment, the HIF-1α and VEGF positive expression rate of the patients in the observation group was apparently lower than that in the control group(P<0.05). Patients in the two groups showed no difference in quality of life before treatment(P>0.05), 3 months after treatment, quality of life of the patients in the observation group was significantly higher than that in the control group(P<0.05); There was no significant difference between the two groups in the incidence of nausea and vomiting, bone marrow suppression, gastrointestinal reaction and abnormal liver and kidney function(P>0.05). Conclusion:Fluorouracil intraperitoneal chemotherapy combined with lymph node dissection showed good therapeutic effect in the treatment of patients with advanced gastric cancer, it can significantly improve the survival rate and quality of life of patients with good application value.