摘要
目的探讨直肠癌术前新辅助化疗效果与血清脱嘌呤脱嘧啶核酸内切酶1自身抗体(APE1-AAbs)和低氧诱导因子-1α(HIF-1α)水平变化的相关性。方法将2015年1月至2016年4月该院接诊的80例直肠癌患者纳入本研究,通过随机数表法分为观察组(n=40)和对照组(n=40),观察组在给予2个疗程的新辅助化疗后再实施手术,对照组术前不进行化疗直接实施手术。比较两组临床疗效、围术期情况、血清APE1-AAbs和HIF-1α的变化、术后并发症及复发率。结果观察组临床疗效总缓解率为52.50%,明显高于对照组的30.00%(P<0.05);两组手术时间、术中出血量比较差异无统计学意义(P>0.05);观察组术后排气时间、排便时间明显短于对照组且保肛率明显高于对照组(P<0.05);治疗后,血清APE1-AAbs、HIF-1α较治疗前均显著降低(P<0.05),观察组血清APE1-AAbs、HIF-1α水平明显低于对照组[(2.17±0.15)ng/mL vs.(2.48±0.17)ng/mL,(104.34±16.21)pg/mL vs.(147.94±17.52)pg/mL,均P<0.05];两组尿路感染、吻合口瘘、吻合口出血、肠梗阻、尿潴留总发生率分别为22.50%、30.00%,差异无统计学意义(P>0.05);1年的随访显示,观察组复发率为10.00%,明显低于对照组的30.00%(P<0.05)。结论直肠癌患者术前给予新辅助化疗效果显著,可明显提高疾病缓解率、保肛率,促进术后恢复,且可降低复发率,其内在机制可能与血清APE1-AAbs、HIF-1α水平降低相关。
Objective To study the correlation between the effect of neoadjuvant chemotherapy before operation on rectal cancer and the concentration changes of serum apurinic/apyrimidinic endonuclease 1 autoanti-bodies(APE1-AAbs)and Hypoxia inducible factor-1α(HIF-1α).Methods A total of 80 patients of rectal cancer who received therapy from January 2015 to April 2016 in the hospital were enrolled in the study.According to random number table,those patients were divided into the observation group(n=40)and the control group(n=40),the observation group received 2 courses of neoadjuvant chemotherapy before the implementation of surgery,the control group received operation without chemotherapy before operation.The clinical efficacy,perioperative situation,concentraton changes of serum APE1-AAbs and HIF-1α,postoperative complications and recurrence rate were compared between the two groups.Results The total remission rate in the observation group was 52.50%,which was significantly higher than that of 30.00%in the control group(P<0.05);there was no significant difference in operation time and intraoperative blood loss between the two groups(P>0.05),the postoperative exhaust time and defecation time in the observation group were significantly shorter than that of the control group,and the sphincter preserving rate was significantly higher than that of the control group(P<0.05);after treatment,serum APE1-AAbs and HIF-1αwere significantly lower than those before treatment(P<0.05),the serum concentrations of APE1-AAbs and HIF-1αin the observation group were significantly lower than that of the control group[(2.17±0.15)ng/mL vs.(2.48±0.17)ng/mL,(104.34±16.21)pg/mL vs.(147.94±17.52)pg/mL,P<0.05];the total incidence of urinary tract infection,anastomotic leakage,anastomotic bleeding,intestinal obstruction and urinary retention in the two groups were 22.50%and 30%,and there was no significant difference between the two groups(P>0.05);the follow-up information of one year showed that the recurrence rate in the observation group was 10%,which was significantly lower than of 30%in the control group(P<0.05).Conclusion Neoadjuvant chemotherapy before operation is well for rectal cancer,which can effectively improve the remission rate and sphincter preserving rate,promote postoperative recovery,and reduce the recurrence rate,The underlying mechanism may be related to the decreased expression of APE1-AAbs and HIF-1αin serum..
作者
王春娟
WANG Chunjuan(Department of Clinical Laboratory,Wendeng Orthopaedic Hospital,Weihai,Shandong 264400,China)
出处
《国际检验医学杂志》
CAS
2019年第18期2256-2259,2263,共5页
International Journal of Laboratory Medicine
作者简介
王春娟,女,副主任技师,主要从事骨折患者创面感染病原菌分布及耐药性分析的研究。
