Objective To investigate the effects of Xelox chemotherapy regimen in the treatment of advanced gastric cancer and its effects on serum carcinoembryonic antigen (CEA) and cancer antigen (CA) 199. Methods A total of 43 advanced gastric cancer patients, who received Xelox chemotherapy regimen in Department of Internal Medi-cine-Oncology of our hospital from January 2013 to October 2015, were selected as research objects. The efficacy of che-motherapy was evaluated by solid tumor evaluation standard. The levels of CEA and CA199 were detected by chemilu-minescence method before and after chemotherapy. All patients were assigned into the disease control group and the dis-ease progression group, according to the efficacy of chemotherapy. The changes of CEA and CA199 in two groups were compared, and the relationship between CEA, CA199 and the chemotherapy efficiency was analyzed. In addition, the median survival of patients with different levels of CEA and CA199 was analyzed. Results After chemotherapy, there were 0 case of complete remission (CR), 9 (20.9％) cases of partial remission (PR), 13 (30.2％) cases of stable disease (SD), 21 (48.8％) cases of progressive disease (PD), with objective response rate (ORR) of 20.9％ (9/43), and disease control rate (DCR) of 51.2％(22/43);the levels of CEA and CA199 were respectively (9.1±5.2) mg/L and (121.3±33.4) mg/L in the disease control group versus (20.4 ± 9.3) mg/L and (219.6 ± 67.3) mg/L in the disease progression group (P<0.05);the degree of declining of CEA and CA199 were respectively (73.1 ± 10.4)％and (59.7 ± 8.3)％in the disease con-trol group versus (45.3 ± 9.1)％ and (37.6 ± 9.6)％ in the disease progression group (P<0.05). The decrease of CEA and CA199 levels was positively related to the chemotherapy efficacy, and the difference was statistically significant (r=0.684, 0.715, P<0.05). After chemotherapy, the median survival of patients with low CEA was significantly higher than that of patients with high CEA (7.6 months vs 6.0 months, P<0.05);the median survival of patients with low C199 was significantly higher than that of patients with high C199 (8.2 months vs 5.5 months, P<0.05). The CEA and CA199 levels were negatively correlated with the median survival of the patients, and the difference was statistically significant (r=-0.631,-0.694, P<0.05). Conclusion The levels of CEA and CA199 are decreased after chemotherapy in advanced gastric cancer patients, and the extent of decline is positively correlated with the chemotherapy efficacy and negatively correlated with median survival.%目的 探讨Xelox化疗方案一线治疗晚期胃癌的疗效及其对血清癌胚抗原(CEA)和糖类抗原199(CA199)水平的影响.方法 选取2013年1月至2015年10月在普宁市人民医院肿瘤内科接受Xelox方案一线化疗的43例晚期胃癌患者为研究对象.采用化学发光法检测患者化疗前后的CEA和CA199水平,采用实体瘤疗效评价法评估化疗疗效,根据化疗疗效将患者分为疾病控制组和疾病进展组,比较两组患者的CEA和CA199水平,并分析其与化疗疗效的关系.此外,还分析不同水平CEA和CA199患者的中位生存期.结果 43例患者化疗后,CR 0例,PR 9例(20.9％),SD 13例(30.2％),PD 21例(48.8％),ORR 20.9％(9/43),DCR 51.2％(22/43);化疗后,疾病控制组和疾病进展组患者CEA[(9.1±5.2)mg/L vs(20.4±9.3)mg/L]和CA199[(121.3±33.4)mg/L vs(219.6±67.3)mg/L]水平比较,差异均有统计学意义(P<0.05);疾病控制组和疾病进展组患者CEA[(73.1±10.4)％vs(45.3±9.1)％]和CA199[(59.7±8.3)％vs(37.6±9.6)％]水平比较,疾病控制组患者的下降幅度更明显,差异均有统计学意义(P<0.05);CEA和CA199水平下降幅度与化疗疗效呈正相关(r=0.684、0.715,P<0.05);CEA低、高水平患者中位生存期分别为7.6个月和6.0个月,差异有统计学意义(P<0.05);CA199低、高水平患者中位生存期分别为8.2个月和5.5个月,差异有统计学意义(P<0.05);CEA和CA199水平与患者中位生存期呈负相关(r=-0.631、-0.694,P<0.05).结论 晚期胃癌患者化疗后CEA和CA199水平下降明显,且下降幅度与化疗疗效呈正相关;化疗后CEA和CA199水平与患者中位生存期呈负相关.
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