全身静脉化疗联合区域动脉灌注化疗栓塞对局部进展期胃癌恶性程度的影响

摘要

Objective: To study the effect of systemic intravenous chemotherapy combined with regional arterial perfusion chemoembolization on the malignancy of locally advanced gastric cancer.Methods: A total of 90 patients with primary gastric cancer who received treatment in Tianyou Hospital Affiliated to Wuhan University of Science & Technology were collected and divided into control group and observation group according to the random number table method, 45 cases in each group.The control group of patients received routine systemic intravenous chemotherapy and surgical treatment, and the observation group of patients received systemic intravenous chemotherapy combined with local arterial perfusion chemoembolization and surgical treatment.Levels of tumor markers and angiogenesis factors in serum as well as the expression of oncogenes and tumor suppressor genes in gastric cancer tissue were compared between the two groups of patients before and after chemotherapy.Results: Before chemotherapy, the levels of tumor markers and angiogenesis factors in serum as well as the expression of oncogenes and tumor suppressor genes in gastric cancer tissue were not significantly different between the two groups of patients;after chemotherapy, serum CEA, CA724, CA242, AFP, VEGF, Ang-2, COX2 and PD-ECGF levels of observation group were lower than those of control group, and iASPP, p130Cas, ERBB2 and C-myc mRNA expression in gastric cancer tissue were lower than those of control group while GKN1, p16, PTEN, TSPYL5 and merlin mRNA expression in gastric cancer tissue were higher than those of control group.Conclusions: Preoperative systemic intravenous chemotherapy combined with regional arterial perfusion chemoembolization can effectively reduce the malignancy of locally advanced gastric cancer and provide favorable conditions for the operation.%目的:探讨全身静脉化疗联合区域动脉灌注化疗栓塞对局部进展期胃癌恶性程度的影响.方法:收集在本院接受治疗的原发性胃癌患者90例,按照随机数表法分为对照组、观察组各45例.对照组接受常规全身静脉化疗+手术治疗,观察组接受全身静脉化疗联合区域动脉灌注化疗栓塞+手术治疗.对比两组化疗前后血清中肿瘤标志物、血管生成因子含量的差异,胃癌组织中癌基因、抑癌基因表达量的差异.结果:化疗前,两组血清中肿瘤标志物、血管新生因子的含量以及胃癌组织中癌基因、抑癌基因的表达量无显著性差异;化疗后,观察组血清中CEA、CA724、CA242、AFP、VEGF、Ang-2、COX2、PD-ECGF的含量低于对照组,胃癌组织中iASPP、p130Cas、ERBB2、C-myc mRNA的表达量低于对照组,胃癌组织中GKN1、p16、PTEN、TSPYL5、merlin mRNA的表达量高于对照组.结论:术前应用全身静脉化疗联合区域动脉灌注化疗栓塞,可有效降低局部进展期胃癌的恶性程度,为手术提供良好条件.