摘要
目的分析Ⅳ期胃癌伴肝转移的临床病理特点及消癌平联合CapeOX方案的疗效。方法选取89例Ⅳ期胃癌伴肝转移患者,根据入院顺序分为单纯化疗组42例及联合组47例;另选60例于我院治疗的晚期不伴肝转移的胃癌患者作对照。收集伴与不伴肝转移患者临床资料,比较两者病理特征。单纯化疗组给予CapeOX方案治疗,联合组在CapeOX方案基础上给予消癌平,比较2组疗效。结果胃癌伴或不伴肝转移患者在性别、年龄、有无肝炎病史、肿瘤位置、有无神经侵犯方面,差异无统计学意义(P>0.05);胃癌伴肝转移患者肿瘤直径>5 cm、有淋巴结转移多于不伴肝转移患者(P<0.05)。单纯化疗组4例CR、12例PR、17例SD、9例PD,联合组分别为8例、20例、16例、3例,联合组有效率(59.57%)、控制率(93.62%)均高于单纯化疗组(38.10%、78.57%)(P<0.05)。治疗后2组MMP-2、MMP-7、MMP-9表达有所下降,且联合组组表达量低于单纯化疗组(P<0.05)。联合组白细胞减少、血小板下降、手足综合征等不良反应少于单纯化疗组(P<0.05)。结论Ⅳ期胃癌伴肝转移患者多有淋巴结转移且肿瘤直径大,经消癌平联合CapeOX方案治疗可有效改善患者症状体征,提高疗效,抑制肿瘤侵袭分子表达并减少不良反应,是临床治疗Ⅳ期胃癌伴肝转移的有效方案。
Objective To analyze the clinicopathological characteristics of stageⅣgastric cancer with liver metastasis,and to discuss the clinical response of Xiaoaiping combined with capecitabine and oxaliplatin(CapeOx)regimen.Methods 89 stageⅣgastric cancer patients with liver metastasis were divided into 2 groups by admission orders,chemotherapy group(n=42)and combined group(n=47),meantime,another 60 advanced gastric cancer patients without liver metastasis were selected as the controls.The clinical data of patients with and without liver metastasis were collected,and the pathological features were compared.The chemotherapy group was given CapeOX regimen,and combined group was given Xiaoaiping combined with CapeOX regimen.Then the clinical response of the 2 groups was compared.Results Data including gender,age,history of hepatitis,tumor location and nerve invasion yielded no significant difference between gastric cancer patients with and without liver metastasis(P>0.05).The proportion of patients with tumor diameter>5cm and lymph node metastasis was significantly higher in gastric cancer patients with liver metastasis than those without liver metastasis(P<0.05).There were 4 cases of complete response(CR),12 cases of partial response(PR),17 cases of stable disease(SD)and 9 cases of progressive disease(PD)in chemotherapy group,and there were 8 cases of CR,20 cases of PR,16 cases of SD and 3 cases of PD in combined group.The overall response rate and control rate were 59.57%and 93.62%in combined group,which were significantly higher than 38.10%and 78.57%in chemotherapy group(P<0.05).After treatment,the expression levels of matrix metalloproteinases-2,7 and 9(MMP-2,MMP-7 and MMP-9)were decreased in both groups,and the expression of the above three parameters were lower in combined group than in chemotherapy group(P<0.05).The incidence rate of adverse reactions such as leukopenia,thrombocytopenia and hand-foot syndrome in combined group was less than that in chemotherapy group(P<0.05).Conclusion The majority of stageⅣgastric cancer patients with liver metastases have lymph node metastasis and large tumor diameter,and the application of Xiaoaiping combined with CapeOX regimen can effectively improve the clinical symptoms and signs,inhibit the expression of tumor invasive molecules and reduce adverse effects,which is worthy of clinical promotion.
作者
许阳阳
贺春娇
李红霞
XU Yangyang;HE Chunjiao;LI Hongxia(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)
出处
《实用癌症杂志》
2023年第5期807-810,共4页
The Practical Journal of Cancer
关键词
胃癌
肝转移
临床病理
消癌平
奥沙利铂
卡培他滨
疗效
Gastric cancer
Liver metastasis
Clinicopathology
Xiaoaiping
Oxaliplatin
Capecitabine
Clinical response
