2020 年第 4 期 第 15 卷

替吉奥联合顺铂对老年进展期胃癌患者相关细胞因子水平及免疫功能的影响

Effect of tegafur, gimeracil and oteracil potassium capsules combined with cisplatin on relevant cytokines and immune function in patients with advanced gastric cancer

作者：许超汤滨滨许书杰周芸夏守慧樊榕

英文作者：Xu Chao Tang binbin Xu Shujie Zhou Yun Xia Shouhui Fan Rong

单位：中国人民解放军陆军第七十二集团军医院检验病理科，浙江省湖州市313000

英文单位：Department of Laboratory Pathology the Seventy-Second Group Military Hospital of the Chinese People′s Liberation Army Ground Force Zhejiang Province Huzhou 313000 China

关键词：胃癌；替吉奥；顺铂；免疫功能；基质细胞衍生因子1；CXC类趋化因子受体4；人表皮生长因子受体2

英文关键词：Gastriccancer;Tegafur,gimeracilandoteracilpotassiumcapsules;Cisplatin;Immunefunction;Stromalcellderivedfactor-1;CXC-chemokinereceptor4;Humanepidermalgrowthfactorreceptor2

• 摘要：

• 【摘要】目的    观察替吉奥联合顺铂对老年进展期胃癌患者血清基质细胞衍生因子1（SDF-1）、CXC趋化因子受体4（CXCR4）、人表皮生长因子受体2（HER2）水平及免疫功能的影响。方法    选取2017年1月至2019年1月中国人民解放军陆军第七十二集团军医院收治的老年进展期胃癌患者136例为研究对象。采用随机数字表法分为对照组和观察组，各68例。2组患者均采取放射治疗。在此基础上，对照组患者接受顺铂治疗，观察组患者接受替吉奥联合顺铂治疗。分析2组患者的临床治疗效果，并观察2组患者的不良反应发生情况。对比患者治疗前后血清中SDF-1、CXCR4、HER2水平及免疫功能指标的变化。结果    观察组总有效率高于对照组［85.3%（58/68）比69.1%（47/68）］，差异有统计学意义（χ2=1.997，P=0.001）。治疗前2组SDF-1、CXCR4及HER2水平差异均无统计学意义（均P>0.05）。治疗后2组SDF-1、CXCR4及HER2水平均低于治疗前，且观察组低于对照组［（13.8±2.1）μg/L比（19.9±3.6）μg/L、（19±3）μg/L比（26±5）μg/L、（10.4±1.5）μg/L比（13.3±1.9）μg/L］，差异均有统计学意义（均P<0.05）。2组患者治疗后CD+3、CD+4及CD+4/CD+8比值明显低于治疗前，而CD+8水平明显高于治疗前，差异均有统计学意义（均P<0.05）；但治疗前、治疗后2组各指标比较差异均无统计学意义（均P>0.05）。2组患者治疗后不良反应发生率差异无统计学意义（χ2=0.563，P=0.185）。结论    与单用顺铂比较，替吉奥联合顺铂对老年进展期胃癌患者临床效果改善显著，能降低血清SDF-1、CXCR4、HER2水平，但对免疫功能无额外的影响，且不增加不良反应发生。

• 【Abstract】Objective    To observe the effect of tegafur, gimeracil and oteracil potassium capsules combined with cisplatin on serum levels of stromal cell derived factor-1(SDF-1), CXC-chemokine receptor 4(CXCR4), human epidermal growth factor receptor 2(HER2) and immune function in elderly patients with advanced gastric cancer. Methods    A total of 136 elderly patients with advanced gastric cancer were enrolled from January 2017 to January 2019 in the Seventy-Second Group Military Hospital of the Chinese People′s Liberation Army Ground Force. The patients were randomly divided into control group and observation group, with 68 cases in each group. Both groups were treated with radiotherapy. The control group was treated with cisplatin and the observation group was treated with cisplatin plus tegafur, gimeracil and oteracil potassium capsules. Clinical effect and adverse reactions were observed. Changes of serum SDF-1, CXCR4, HER2 and immune function indexes were analyzed. Results    Total effective rate in observation group was significantly higher than that in control group［85.3%（58/68） vs 69.1%（47/68）］（χ2=1.997，P=0.001）. There were no significant differences in levels of serum SDF-1, CXCR4 and HER2 between groups before treatment（all P>0.05）. After treatment, serum levels of SDF-1, CXCR4 and HER2 significantly decreased in both groups and the indexes in observation group were lower than those in control group［（13.8±2.1）μg/L vs （19.9±3.6）μg/L, （19±3）μg/L vs （26±5）μg/L, （10.4±1.5）μg/L vs （13.3±1.9）μg/L］(all P<0.05). Levels of CD+3, CD+4 and CD+4/CD+8 ratio decreased and CD+8 increased after treatment(all P<0.05); no statistical difference was observed between groups（all P>0.05）. There was no significant difference in the incidence of adverse reactions between groups(χ2=0.563，P=0.185). Conclusions    Compared with cisplatin alone, tegafur, gimeracil and oteracil potassium capsules combined with cisplatin is effective in treating elderly patients with advanced gastric cancer. It can reduce serum contents of SDF-1, CXCR4, HER2 and shows no side effect on immune function.