摘要
目的探究胃癌根治术联合术后洛铂腹腔热灌注对进展期胃癌的治疗效果及对One Cut同源盒蛋白2(ONECUT2)基因、Yes相关蛋白1(YAP1)mRNA表达的影响。方法选取2021年6月至2023年6月某医院收治的120例进展期胃癌患者为研究对象,采用随机数字表法将患者分为联合组和对照组,每组60例。联合组采用胃癌根治术联合术后洛铂腹腔热灌注治疗方案,对照组采用胃癌根治术联合常规化疗(卡培他滨+顺铂)方案。比较两组进展期胃癌患者的疗效、手术相关指标,治疗前后血清相关肿瘤指标、并发症及随访1年的预后情况。结果联合组进展期胃癌患者治疗总有效率高于对照组,部分缓解(PR)率高于对照组,进展(PD)率低于对照组(P<0.05)。两组术中出血量、术后48 h视觉模拟疼痛(VAS)评分、手术切口长度和术后肛门排气时间比较,差异无统计学意义(P>0.05),但联合组手术时间比对照组长(P<0.05)。与治疗前相比,联合组治疗后血清ONECUT2基因和YAP1 mRNA表达均下降,血清癌胚抗原(CEA)和糖类抗原199(CA199)水平均降低(P<0.05);治疗后,联合组血清ONECUT2基因和YAP1 mRNA表达、CEA和CA199水平均低于对照组(P<0.05)。联合组和对照组并发症总发生率分别为25.00%和15.00%,差异无统计学意义(P>0.05)。联合组患者中位生存期>12个月,对照组患者中位生存期为11.18个月(P<0.05)。结论胃癌根治术联合术后洛铂腹腔热灌注用于治疗进展期胃癌能有效提高疗效,下调ONECUT2基因、YAP1 mRNA表达,不增加并发症风险,且有利于延长生存期,但手术时间较长。
Objective To explore the therapeutic effect of radical gastrectomy combined with postoperative hyperthermic intraperitoneal chemotherapy(HIPEC)of lobaplatin on progressive gastric cancer and its influence on One Cut homeobox 2(ONECUT2)gene and Yes-associated protein 1(YAP1)mRNA expression.Methods A total of 120 patients with progressive gastric cancer admitted to a hospital from June 2021 to June 2023 were selected as the study objects by simple random sampling method.They were divided into a combined group(n=60)and a control group(n=60)by simple random number table method.The combined group was treated with radical gastrectomy combined with postoperative HIPEC of lobaplatin,while the control group was given radical gastrectomy combined with conventional chemotherapy(capecitabine+cisplatin).The efficacy,surgery-related indicators,serum tumor related indicators before and after treatment,complications and 1-year follow-up prognosis were compared between the two groups.Results Compared with the control group,the combined group exhibited a higher total effective rate,more cases of partial response(PR),and fewer cases of progressive disease(PD)(P<0.05).There was no statistically significant difference in intraoperative blood loss,Visual Analogue Scale(VAS)score at 48 h after surgery,surgical incision length,and postoperative anal exhaust time between the two groups(P>0.05).However,the operative duration in the combined group was longer than that in the control group(P<0.05).After treatment,the serum expression levels of ONECUT2 gene,YAP1 mRNA,carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)in the combined group were lower than those before treatment(P<0.05),and the above indicators in the combined group were lower than those in the control group(P<0.05).There was no statistically significant difference in the total incidence of complications between 25.00%in the combined group and 15.00%in the control group(P>0.05).The median survival of patients was greater than 12 months in the combined group and 11
作者
郭宏果
陆婉玲
杨尚臻
刘军
乔松
程才
寇伟伟
Guo Hongguo;Lu Wanling;Yang Shangzhen;Liu Jun;Qiao Song;Cheng Cai;Kou Weiwei(Department of Oncology and Hematology,986 th Hospital of PLA Air Force,Xi'an 710054,China;Department of General Surgery,986 th Hospital of PLA Air Force,Xi'an 710054,China)
出处
《成都医学院学报》
CAS
2024年第6期949-953,共5页
Journal of Chengdu Medical College
基金
陕西省科学技术厅重点研发计划项目(No:2021SF-344)。
关键词
胃癌根治术
洛铂
腹腔热灌注
进展期胃癌
One
Cut同源盒蛋白2
Yes相关蛋白1
Radical gastrectomy
Lobaplatin
Hyperthermic intraperitoneal chemotherapy
Progressive gastric cancer
One Cut homeobox 2
Yes-associated protein 1
