2017 年第 2 期 第 15 卷

奥沙利铂联合卡培他滨或替吉奥对晚期结肠癌患者血浆miR-21表达水平的影响及疗效对比

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关键词：直肠癌奥沙利铂卡培他滨替吉奥疗效

• 摘要：
• 【摘要】目的：探究奥沙利铂联合卡培他滨或联合替吉奥对晚期结肠癌患者治疗效果及对miR-21的影响。方法：选取2013年8月至2014年9月来我院就诊的直肠癌患者112例，依据抽签法将患者分为卡培他滨组和替吉奥组各56例；给予卡培他滨组患者奥沙利铂联合卡培他滨进行化学药物治疗，给予替吉奥组患者奥沙利铂联合替吉奥进行治疗。观察比较两组患者治疗前后的白细胞计数（WBC）、血小板计数（PLT）、miR-21水平及恶心呕吐、手足综合症（HFS）、口腔黏膜炎、肝功能异常例数及总有效率。结果：治疗前两组患者的白细胞计数（WBC）、血小板计数（PLT）及miR-21水平比较差异无统计学意义（P>0.05）；治疗后两组患者的白细胞计数（WBC）、血小板计数（PLT）及miR-21水平较治疗前均明显降低，组间比较卡培他滨组患者的PLT明显高于替吉奥组[（73.25±11.48）×109/L比（68.14±10.64）×109/L]，差异有统计学意义（P<0.05）；治疗过程中卡培他滨组患者出现手足综合症（HFS）及恶心呕吐例数明显高于替吉奥组[41.07%（23/56）比23.21%（13/56），66.07%（37/56）比46.43%（26/56）]，差异有统计学意义（P<0.05）；两组患者的总有效率比较差异无统计学意义（P>0.05）结论：奥沙利铂联合卡培他滨或替吉奥均可对晚期直肠癌患者起到明显治疗效果，且不良反应各有优劣，两者均可作为直肠癌的临床治疗方案。且miR-21的表达水平可作为结肠癌的疗效评价指标。
• To explore the effect of expression of miR-21 of oxaliplatin combined with capecitabine or Tegafur Gimeracil Oteracil Potassium(TGOP) for patients with advanced colorectal cancer . Methods: From August 2013 to September 2014,112 cases of patients with colorectal cancer which come to our hospital for treatment were divided into capecitabine group and TGOP group according to the method of lottery,each had 56 cases.The patients of capecitabine group were given oxaliplatin combined with capecitabine for chemotherapy, and the patients of TGOP group were given oxaliplatin and tegitazol for chemotherapy.The White Blood Cell(WBC), platelet count (PLT), miR-21, nausea and vomiting, hand-foot syndrome (HFS), oral mucositis, abnormal liver function and total effective rate of the two groups were compared before and after treatment.Results: There was no significant differences in the WBC, PLT and miR-21 levels between the two groups before treatment (P> 0.05). The WBC , platelet count and miR-21 of the two groups were significantly lower after treatment than before treatment,the platelet count (PLT) of the capecitabine group was higher than that of the TGOP group after treatment[(73.25 ± 11.48) × 109 / L ratio (68.14 ± 10.64) × 109 / L],the difference was statistically significant (P <0.05). The cases of HFS and nausea of capecitabine group were significantly higher than those of the TGOP group[41.07%（23/56） ratio 23.21%（13/56），66.07%（37/56） ratio 46.43%（26/56）], the difference was statistically significant (P <0.05). There was no significant difference in total effective rate between the two groups (P> 0.05). There was no significant difference of the total effective rate between the two groups (P> 0.05) .Conclusion: Oxaliplatin combined with capecitabine or TGOP can treat patients with advanced rectal cancer obviously, and the adverse reactions have advantages and disadvantages, both can be used as rectal cancer of the clinical treatment.And the expression level of miR-21 can be used as the evaluation index of colon cancer.