新辅助化疗对进展期胃癌患者血清VEGF、肿瘤标志物水平的影响

目的评价新辅助化疗对进展期胃癌患者血清血管内皮生长因子(VEGF)、肿瘤标志物水平的影响。方法选择2015年2月至2017年11月就诊于我院的100例进展期胃癌患者,按照随机双盲法将其分为对照组和观察组,各50例。对照组给予DCF化疗方案(顺铂+多西他赛+5-氟尿嘧啶);观察组给予改良FOLFOX6新辅助化疗方案(奥沙利铂+亚叶酸钙+5-氟尿嘧啶)。比较两组临床疗效、化疗前后血清VEGF、肿瘤标志物[糖类抗原125(CA125)、癌胚抗原(CEA)、糖类抗原72-4(CA72-4)、糖类抗原19-9(CA19-9)]水平及不良反应发生情况。结果观察组的治疗总有效率为52.00%,显著高于对照组的32.00%(P<0.05)。化疗后,两组血清VEGF-A、VEGFR-1水平均降低,VEGF-D水平均升高,且观察组均优于对照组(P<0.05)。化疗后,两组血清CA125、CEA、CA72-4及CA19-9水平均显著降低,且观察组低于对照组(P<0.05)。观察组血小板减少、恶心呕吐、白细胞减少及周围神经毒性发生率略低于对照组(P>0.05)。结论采用新辅助化疗方案治疗进展期胃癌效果确切,有助于抑制血清VEGF水平释放,降低肿瘤标志物水平,减缓病情进展,且不增加不良反应。

Effect of neoadjuvant chemotherapy on the levels of serum VEGF and tumor markers in patients with advanced gastric cancer

Objective To evaluate the effect of neoadjuvant chemotherapy on the levels of serum vascular endothelial growth factor(VEGF) and tumor markers in patients with advanced gastric cancer. Methods A total of 100 patients with advanced gastric cancer treated in our hospital from February 2015 to November 2017 were selected and divided into control group and observation group according to random double-blind method, with 50 cases in each group. The control group received DCF chemotherapy(cisplatin+docetaxel+5-fluorouracil);the observation group received improved FOLFOX6 neoadjuvant chemotherapy(oxaliplatin+calcium folinate+5-fluorouracil). The clinical efficacy, levels of serum VEGF and tumor markers [carbohydrate antigen 125(CA125), carcinoembryonic antigen(CEA), carbohydrate antigen 72-4(CA72-4),carbohydrate antigen 19-9(CA19-9)] before and after chemotherapy and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 52.00%, which was significantly higher than 32.00% in the control group(P<0.05). After chemotherapy, the levels of serum VEGF-A and VEGFR-1 in both groups decreased, and the levels of VEGF-D increased, and those in the observation group were better than the control group(P<0.05). After chemotherapy, the levels of serum CA125, CEA, CA72-4 and CA19-9 in the two groups significantly decreased, and those in the observation group were lower than the control group(P<0.05). The incidences of thrombocytopenia, nausea and vomiting, leukopenia and peripheral neurotoxicity in the observation group were slightly lower than those in the control group(P >0.05). Conclusion Neoadjuvant chemotherapy is effective in the treatment of advanced gastric cancer. It is helpful to inhibit the release of serum VEGF, reduce the levels of tumor markers and slow down the progress of the disease, without increasing adverse reactions.