重组人血管内皮抑制素联合多西他赛及卡铂治疗中晚期胃癌的效果及对患者血清基质金属蛋白酶2和血管内皮生长因子水平的影响

摘要

Objective To investigate the effect of recombinant human endostatin combined with docetaxel and carboplatin on serum matrix metalloproteinase-2 (MMP-2) and vascular endothelial growth factor(VEGF) in patients with middle and advanced gastric cancer.Methods Totally 114 patients with middle and advanced gastric cancer who had chemotherapy in Binzhou City Central Hospital of Shandong Province from January 2015 to October 2016 were randomly divided into control group(n =52) and observation group(n =62).The control group was treated with docetaxel plus carboplatin and the observation group was treated with recombinant human endostatin additionally for 2 cycles (1 cycle =21 d).Short-term effect,serum levels of MMP-2 and VEGF and occurrence of toxic side effects were analyzed.Results The short-term effective rate in observation group was significantly higher than that in control group[79.0％ (49/62) vs 61.5％ (32/52)] (P ＜0.05).Serum levels of MMP-2 and VEGF had no significant differences between observation group and control group before treatment [(4 957 ± 413)ng/L vs (4 956 ±401)ng/L,(434 ±65) ng/L vs (432 ±62)ng/L] (P ＞0.05).Serum levels of MMP-2 and VEGF in observation group after treatment were significantly lower than those in control group[(3 917 ± 383)ng/L vs (4 208 ±397)ng/L,(317 ±48)ng/L vs (359 ±50)ng/L] (P ＞0.05).Incidences of mucositis,myelosuppression,gastrointestinal reaction and leucopenia had no significant differences between groups(P ＞ 0.05).Conclusion Recombinant human endostatin combined with docetaxel and carboplatin is effective in treating middle-advanced gastric cancer and lowering serum MMP-2 and VEGF without increasing toxic side effects.%目的 探讨重组人血管内皮抑制素联合多西他赛及卡铂治疗中晚期胃癌的效果及对患者血清基质金属蛋白酶2(MMP-2)和血管内皮生长因子(VEGF)的影响.方法 选取2015年1月至2016年10月于山东省滨州市中心医院肿瘤科接受化疗的114例中晚期胃癌患者,采用随机数字表法分为对照组(52例)和观察组(62例).对照组给予多西他赛和卡铂治疗;观察组在对照组基础上加予重组人血管内皮抑制素注射液治疗;21 d为1个周期,共治疗2个周期.比较2组的近期疗效、血清MMP-2和VEGF水平及毒副反应发生情况.结果 观察组近期治疗有效率明显高于对照组[79.0％ (49/62)比61.5％ (32/52)],差异有统计学意义(P＜0.05).治疗前观察组和对照组MMP-2[(4 957±413) ng/L比(4 956 ±401)ng/L]和VEGF[(434±65) ng/L比(432±62)ng/L]差异均无统计学意义(均P＞0.05).治疗后观察组MMP-2和VEGF均明显低于对照组[MMP-2:(3 917±383) ng/L比(4 208±397) ng/L、VEGF:(317±48) ng/L比(359±50) ng/L],差异均有统计学意义(均P＜0.05).化疗期间2组黏膜炎、骨髓抑制、胃肠道反应及白细胞减少的发生率差异均无统计学意义(均P＞0.05).结论 重组人血管内皮抑制素联合多西他赛及卡铂在治疗中晚期胃癌中应用效果良好,近期治疗有效率高,能够明显降低血清MMP-2和VEGF水平,且不增加毒副反应发生率.