每周脂质体紫杉醇联合替吉奥对老年晚期胃癌患者血清肿瘤标志物与可溶性E-钙黏连蛋白的影响

目的:分析每周脂质体紫杉醇联合替吉奥对老年晚期胃癌患者血清肿瘤标志物与可溶性E-钙黏连蛋白（sEC）影响。方法:87例老年晚期胃癌患者按随机数字表法分为41例对照组和46例试验组。对照组奥利沙铂每次130 mg/m2，静脉滴注，每周期第1天，1个疗程为21 d，持续治疗3个疗程；替吉奥每次50 mg（体表面积>1.25 m-2～1.5 m-2）或者60 mg（体表面积≥1.5 m-2），口服，每周期第1～28天，6周1个疗程，持续治疗2个疗程。试验组替吉奥用法同对照组，脂质体紫杉醇每次60 mg/m2，静脉滴注，每周期第1、8、15、22天，1个疗程为6周。比较两组临床疗效，治疗前后血清肿瘤标志物、sEC水平，不良反应及生存情况分析。结果:治疗后，试验组和对照组疾病控制率分别为65.22%（30例次/46例次）和56.10%（23例次/41例次），1年生存率分别为58.69%（27例次/46例次）和48.78%（20例次/41例次），比较无统计学差异（P>0.05）。试验组和对照组血清癌胚抗原（CEA）水平分别为（9.37±2.03）和（8.99±1.48）ng/mL，糖类抗原125（CA125）分别为（24.08±3.98）和（23.22±3.86）U/mL、糖链抗原19-9（CA19-9）分别为（14.57±2.81）和（15.30±2.22）U/mL，sEC分别为（1 903.87±250.17）和（1 934.37±199.46）ng/mL，比较无统计学差异（P>0.05）。两组不良反应以恶心呕吐、贫血、血小板减少、粒细胞减少、腹泻及肝肾功能异常为主，组间各不良反应发生率比较有统计学差异（P<0.05）。结论:每周脂质体紫杉醇联合替吉奥对老年晚期胃癌患者的效果确切，可降低血清肿瘤标志物和sEC水平，且患者耐受性较好。

Effects of weekly liposome paclitaxel combined with tiggio on serum tumor markers and soluble e-cadherin in elderly patients with advanced gastric cancer

AIM: To analyze the effect of weekly liposome paclitaxel combined with tiggio on serum tumor markers and soluble e-cadherin (sEC) in elderly patients with advanced gastric cancer. METHODS: Eighty-seven elderly patients with advanced gastric cancer were divided into 41 control groups and 46 treatment groups according to the random number table. In the control group, olififloxacin was intravenously instilled at 130 mg/m2 each time, the first day of each cycle was 21 days, and the course of treatment was continued for 3 courses; tiggio each time 50 mg (body surface area>1.25 m-2-1.5 m-2) or 60 mg (body surface area≥1.5 m-2), oral, 1-28 d per cycle, 6 weeks for 1 course, continuous treatment for 2 courses. The usage of tiggio in the treatment group was the same as that in the control group; the liposome paclitaxel was intravenously infused at 60 mg/m2 each time, at the first, eighth, fifteen, and twenty-second days of the cycle, and one course of treatment was 6 weeks. Then clinical efficacy, serum levels of tumor markers, sEC before and after treatment, adverse reactions and survival in both group were compared.RESULTS:After treatment, the disease control rates in the treatment group and the control group were 65.22% (30/46) and 56.10% (23/46), 1-year survival rate was 58.69% (27/46) and 48.78% (20/41) , there was no statistical difference (P>0.05). Serum levels of carcinoembryonic antigen (CEA) in the treatment group and the control group were (9.37±2.03) and (8.99±1.48) ng/mL, carbohydrate antigen 125 (CA125) was (24.08±3.98) and (23.22±3.86) U/mL, the glucose chain antigen 19-9 (CA19-9) was (14.57±2.81) and (15.30±2.22) U/mL, sEC was (1 903.87±250.17) and (1 934.37±199.46) ng/mL, there was no statistical difference (P>0.05). The adverse reactions in the both groups were mainly nausea and vomiting, anemia, thrombocytopenia, granulocytopenia, diarrhea and liver and kidney dysfunction, adverse reaction rate in treatment group and the control group were statistically significant differences (P<0.05). CONCLUSION:The effect of weekly liposome paclitaxel combined with tiggio on elderly patients with advanced gastric cancer is confirmed, it can reduce the level of serum tumor markers and sEC, and patient tolerance is better.