紫杉醇联合拉帕替尼对晚期胃癌的疗效及外周血中FGF、FGFR和免疫功能的影响
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摘要
目的探讨紫杉醇联合拉帕替尼对晚期胃癌的疗效及外周血中成纤维细胞生长因子(FGF)、成纤维细胞生长因子受体(FGFR)和免疫功能的影响。方法选择2016年5月至2017年4月海南省肿瘤医院收治的64例晚期胃癌患者为研究对象进行前瞻性研究,按照数字随机表法将患者随机分为紫杉醇治疗组和联合治疗组,每组各32例。紫杉醇治疗组使用紫杉醇化疗,联合治疗组使用紫杉醇联合拉帕替尼治疗。比较两组患者的疗效、不良反应以及外周血中FGF、FGFR、Ig A、Ig M和Ig G的水平。结果两组患者性别构成比、年龄、病理类型、分化程度、病发部位和TNM分期差异无统计学意义(P> 0. 05);联合治疗组的有效率(53. 13%)和控制率(84. 38%)均显著高于紫杉醇治疗组(21. 88%,59. 38%)(P <0. 05);治疗前两组患者外周血中的FGF、FGFR、Ig A、Ig M和Ig G的水平差异均无统计学意义(P> 0. 05);治疗后紫杉醇治疗组外周血中的FGF(50. 42±8. 76)和FGFR(464. 96±32. 63)水平显著高于联合治疗组[(23. 62±4. 50)、(302. 62±23. 63)],Ig A(1. 41±0. 27)、Ig M(0. 43±0. 15)和Ig G(5. 78±1. 01)的水平显著低于联合治疗组[(1. 95±0. 45)、(0. 57±0. 12)、(7. 73±1. 56)](P <0. 05);紫杉醇治疗组的恶心呕吐、腹泻和粒细胞减少的发生率均显著高于联合治疗组(P <0. 05)。结论紫杉醇联合拉帕替尼对晚期胃癌的治疗较单纯使用紫杉醇具有更佳的治疗效果和安全性,同时具有更佳的改善免疫功能以及降低恶性分子的作用。
Objective To explore the effect of paclitaxel combined with rapatinib in treatment of patients with advanced gastric cancer and their influence on peripheral blood FGF,FGFR and immune function. Methods This is a prospective study. According to the treatment plan,64 patients with advanced gastric cancer admitted in this hospital during May 2016 to April 2017 were selected and divided into paclitaxel treatment group and combined treatment group,each group with 32 cases. Paclitaxel chemotherapy was used in the paclitaxel treatment group and the combination treatment group was treated with Paclitaxel combined with Rapatinib. The curative effect,adverse reactions and the levels of FGF,FGFR,Ig A,Ig M and Ig G in peripheral blood were compared between these two groups. Results There was no significant difference in gender,age,pathological type,differentiation,location and TNM stages between these two groups.( P > 0. 05). The effective rate( 53. 13%) and control rate( 84. 38%) of combined treatment group were significantly higher than those of paclitaxel group( 21. 88%,59. 38%)( P < 0. 05). Before treatment,the levels of FGF,FGFR,Ig A,Ig M and Ig G in peripheral blood of these two groups had no significant difference( P < 0. 05). The levels of FGF( 50. 42 ± 8. 76) and FGFR( 464. 96 ± 32. 63) in peripheral blood of paclitaxel treatment group were significantly higher than those of combinaion treatment group [( 23. 62 ± 4. 50),( 302. 62 ± 23. 63) ]. The levels of Ig A( 1. 41 ± 0. 27),Ig M( 0. 43 ± 0. 15) and Ig G( 5. 78± 1. 01) were significantly lower than those of combination treatment group [( 1. 95 ± 0. 45),( 0. 57 ± 0. 12),( 7. 73 ± 1. 56) ]( P < 0. 05).The incidence of nausea,vomiting,diarrhea,peripheral neurotoxicity and granulocytopenia in paclitaxel treatment group were significantly higher than those of combination treatment group( P < 0. 05). Conclusion The efficacy of paclitaxel combined with rapatinib is better than paclitaxel alone in treatment of patients with advanced gastric cancer. At the same time,they can improve their immune function and reduce the function of malignant molecules.
Objective To explore the effect of paclitaxel combined with rapatinib in treatment of patients with advanced gastric cancer and their influence on peripheral blood FGF,FGFR and immune function. Methods This is a prospective study. According to the treatment plan,64 patients with advanced gastric cancer admitted in this hospital during May 2016 to April 2017 were selected and divided into paclitaxel treatment group and combined treatment group,each group with 32 cases. Paclitaxel chemotherapy was used in the paclitaxel treatment group and the combination treatment group was treated with Paclitaxel combined with Rapatinib. The curative effect,adverse reactions and the levels of FGF,FGFR,Ig A,Ig M and Ig G in peripheral blood were compared between these two groups. Results There was no significant difference in gender,age,pathological type,differentiation,location and TNM stages between these two groups.( P > 0. 05). The effective rate( 53. 13%) and control rate( 84. 38%) of combined treatment group were significantly higher than those of paclitaxel group( 21. 88%,59. 38%)( P < 0. 05). Before treatment,the levels of FGF,FGFR,Ig A,Ig M and Ig G in peripheral blood of these two groups had no significant difference( P < 0. 05). The levels of FGF( 50. 42 ± 8. 76) and FGFR( 464. 96 ± 32. 63) in peripheral blood of paclitaxel treatment group were significantly higher than those of combinaion treatment group [( 23. 62 ± 4. 50),( 302. 62 ± 23. 63) ]. The levels of Ig A( 1. 41 ± 0. 27),Ig M( 0. 43 ± 0. 15) and Ig G( 5. 78± 1. 01) were significantly lower than those of combination treatment group [( 1. 95 ± 0. 45),( 0. 57 ± 0. 12),( 7. 73 ± 1. 56) ]( P < 0. 05).The incidence of nausea,vomiting,diarrhea,peripheral neurotoxicity and granulocytopenia in paclitaxel treatment group were significantly higher than those of combination treatment group( P < 0. 05). Conclusion The efficacy of paclitaxel combined with rapatinib is better than paclitaxel alone in treatment of patients with advanced gastric cancer. At the same time,they can improve their immune function and reduce the function of malignant molecules.
引文
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[10] Chen CT,Kim H,Liska D,et al. MET activation mediates resistance to lapatinib inhibition of HER2-amplified gastric cancer cells[J]. Mol Cancer Ther,2012,11(3):660-669.
[11] LabonteMJ,Wilson PM,Fazzone W,et al. Evaluation of the dual tyrosine kinase inhibitor lapatinib in combination with 5-fluo-rouracil and SN-38 in colon and gastric cell line models[J]. J Clin Oncol,2008,26(15):14643.
[12]徐晚成.抗癌药物紫杉醇的作用机理及机制[J].滨州医学院学报,2017,40(4):294-297.
[13]张丽华,李静.曲妥珠单抗联合紫杉醇诱导过表达HER-2的乳腺癌裸鼠皮下移植瘤乳腺癌细胞凋亡的作用机制和效果研究[J].临床和实验医学杂志,2016,15(14):1373-1377.
[14]王妹兴,肖谜.替吉奥分别联合紫杉醇与奥沙利铂在胃癌术后辅助化疗的应用比较[J].贵州医药,2018,42(3):297-299.
[15]邱晓彦.非B细胞来源的免疫球蛋白促进肿瘤的发生和发展[J].中国肿瘤生物治疗杂志,2015,22(2):183-190.
[16]赖琳,马虹,黄楚鹰,等.贝伐单抗对胃移植癌裸鼠VEFG、IL-8、bFGF表达的影响[J].肿瘤药学,2017,7(2):164-168.
[2]陈钟,唐庆林,韩忠政,等.胃癌的治疗进展[J].国际消化病杂志,2017,37(2):77-78,91.
[3]陈淑慧,阳帆帆,何君,等.胃癌靶向治疗研究最新进展[J].中国临床药理学与治疗学,2015,20(8):950-955.
[4]刘君,杨艳芳,顾林.曲妥珠单抗在HER-2阳性乳腺癌患者新辅助治疗中的应用研究进展[J].中国肿瘤临床,2014,41(16):1065-1068.
[5]吴珍珍.酪氨酸激酶抑制剂治疗晚期胃癌的新进展[J].实用医学杂志,2015,31(10):1718-1720.
[6]刘文静,赵艳秋,胡秀峰,等.紫杉醇脂质体联合替吉奥治疗晚期胃癌的有效性及安全性评价[J].郑州大学学报(医学版),2014,49(6):783-786.
[7]刘坤,李国立,范朝刚,等. Choi标准在胃癌术前化疗疗效评价中的应用[J].实用临床医药杂志,2016,20(11):54-58.
[8] Sano T,Coit DG,Kim HH,et al. Proposal of a new stage grouping of gastric cancer for TNM classification:Interna-tional Gastric Cancer Association staging project[J]. Gastric Cancer,2017,20(2):217-225.
[9] Kim JW,Kim HP,Im SA,et al. The growth inhibitory effect of lapatinib,a dual inhibitor of EGFR and HER2 tyrosine kinase,in gastric cancer cell lines[J]. Cancer Lett,2016,272(2):296-306.
[10] Chen CT,Kim H,Liska D,et al. MET activation mediates resistance to lapatinib inhibition of HER2-amplified gastric cancer cells[J]. Mol Cancer Ther,2012,11(3):660-669.
[11] LabonteMJ,Wilson PM,Fazzone W,et al. Evaluation of the dual tyrosine kinase inhibitor lapatinib in combination with 5-fluo-rouracil and SN-38 in colon and gastric cell line models[J]. J Clin Oncol,2008,26(15):14643.
[12]徐晚成.抗癌药物紫杉醇的作用机理及机制[J].滨州医学院学报,2017,40(4):294-297.
[13]张丽华,李静.曲妥珠单抗联合紫杉醇诱导过表达HER-2的乳腺癌裸鼠皮下移植瘤乳腺癌细胞凋亡的作用机制和效果研究[J].临床和实验医学杂志,2016,15(14):1373-1377.
[14]王妹兴,肖谜.替吉奥分别联合紫杉醇与奥沙利铂在胃癌术后辅助化疗的应用比较[J].贵州医药,2018,42(3):297-299.
[15]邱晓彦.非B细胞来源的免疫球蛋白促进肿瘤的发生和发展[J].中国肿瘤生物治疗杂志,2015,22(2):183-190.
[16]赖琳,马虹,黄楚鹰,等.贝伐单抗对胃移植癌裸鼠VEFG、IL-8、bFGF表达的影响[J].肿瘤药学,2017,7(2):164-168.
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