2022 年第 10 期 第 17 卷

伊立替康联合阿帕替尼辅助治疗术后转移性胃癌患者的效果分析

Effect of irinotecan combined with apatinib on the adjuvant treatment of postoperative metastatic gastric cancer

作者：陶振洲秦薛斌曹广骆成玉

英文作者：Tao Zhenzhou Qin Xuebin Cao Guang Luo Chengyu

单位：首都医科大学附属北京安贞医院普外科，北京100029

英文单位：Department of General Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：转移性胃癌；伊立替康；阿帕替尼；生存质量

英文关键词：Metastaticgastriccancer;Irinotecan;Apatinib;Qualityoflife

• 摘要：

• 目的 探讨伊立替康联合阿帕替尼辅助治疗对术后转移性胃癌患者的效果。方法 选取2016年1月至2021年1月在首都医科大学附属北京安贞医院接受治疗的术后转移性胃癌患者68例，按随机数字表法分为观察组与对照组，各34例。对照组给予伊立替康静脉滴注治疗；观察组在对照组基础上口服阿帕替尼辅助治疗。比较2组治疗后临床疗效，用药前后免疫功能指标CD+3、CD+4、CD+8水平及CD+4/CD+8比值，肿瘤标志物糖类抗原19-9（CA19-9）、CA125、神经元特异性烯醇化酶（NSE）水平，炎性因子白细胞介素10（IL-10）、IL-6、肿瘤坏死因子α（TNF-α）水平，生存质量评分和不良反应发生情况。结果 观察组总有效率明显高于对照组［85.3%（29/34）比61.8%（21/34）］，差异有统计学意义（P=0.028）。用药后观察组免疫功能指标CD+3、CD+4水平及CD+4/CD+8比值均高于对照组，CD+8水平低于对照组，肿瘤标志物CA19-9、CA125、NSE水平均明显低于对照组，炎性因子IL-10、IL-6、TNF-α水平均低于对照组，各维度生存质量评分均高于对照组，差异均有统计学意义（均P＜0.05）。2组不良反应发生率比较，差异无统计学意义（P=0.494）。结论 术后转移性胃癌患者采取伊立替康联合阿帕替尼辅助治疗的效果较好，可增强患者免疫能力，促进肿瘤标志物改善，减轻炎性反应，并提升患者生存质量。

• Objective  To explore the effect of irinotecan combined with apatinib on the adjuvant treatment of postoperative metastatic gastric cancer. Methods Sixty-eight patients with postoperative metastatic gastric cancer admitted to Beijing Anzhen Hospital, Capital Medical University from January 2016 to January 2021 were enrolled. Patients were randomly divided into observation group and control group, with 34 cases in each group. The control group was treated with irinotecan intravenous drip, and the observation group was treated with apatinib orally on the basis of the control group. The clinical efficacy, levels of immune function indexes CD+3, CD+4, CD+8 and the ratio of CD+4/CD+8, levels of tumor markers carbohydrate antigen 19-9 (CA19-9), CA125, neuron specific enolase (NSE), levels of inflammatory factors interleukin-10 (IL-10), IL-6 and tumor necrosis factor-α（TNF-α）, quality of life score and incidence of adverse reactions were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group［85.3%（29/34） vs 61.8%（21/34）］(P=0.028). After treatment, the levels of immune function indexes CD+3, CD+4 and the ratio of CD+4/CD+8 in the observation group were higher than those in the control group, the level of CD+8 was lower than that in the control group, the levels of tumor markers CA19-9, CA125 and NSE were significantly lower than those in the control group, the levels of inflammatory factors IL-10, IL-6 and TNF- α were lower than those in the control group, and the score of quality of life each dimension was higher than that in the control group (all P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P=0.494). Conclusion Irinotecan combined with apatinib is effective in the adjuvant treatment of postoperative metastatic gastric cancer. It can enhance the immune ability of patients, promote the improvement of tumor markers, reduce inflammatory reaction and improve the quality of life of patients.