5-氟尿嘧啶联合奥沙利铂对结直肠癌患者肿瘤标志物、免疫功能及血清TGF-β1、MMP-7、Smad-7的影响#br#

摘要/Abstract

摘要： 目的：探讨5-氟尿嘧啶联合奥沙利铂治疗结直肠癌患者的临床价值及对肿瘤标志物、免疫功能及血清转化生长因子（TGF）-β1、基质金属蛋白酶（MMP）-7、Smad-7的影响。方法：选取我院2019年5月至2022年5月收治的结直肠癌患者120例，按信封随机法将其分为试验组（n=60）、对照组（n=60）两组。对照组患者施行5-氟尿嘧啶治疗，试验组患者施行5-氟尿嘧啶联合奥沙利铂治疗。比较两组患者给药前、给药6周后的免疫功能、各项肿瘤标志物、血清TGF-β1、MMP-7和Smad-7指标。结果：试验组患者经5-氟尿嘧啶联合奥沙利铂治疗后，有效率为76.67%，高于对照组经5-氟尿嘧啶治疗后的有效率58.33%（P<0.05）。给药6周后，两组患者CD4+指标和CD4+/CD8+比值均升高，CA153、CD8+、CA242和CA19-9指标均降低，且试验组患者CD4+指标和CD4+/CD8+比值升高幅度均大于对照组（P<0.05），CA153、CD8+、CA242和CA19-9指标降低幅度均大于对照组（P<0.05）。给药6周后，两组患者TGF-β1和MMP-7指标均降低，Smad-7指标升高，且试验组患者TGF-β1和MMP-7指标降低幅度均大于对照组（P<0.05），Smad-7指标升高幅度大于对照组（P<0.05）。结论：在结直肠癌患者治疗中，5-氟尿嘧啶联合奥沙利铂的临床疗效显著，有助于改善其免疫功能，降低肿瘤标志物水平，可调节TGF-β1、MMP-7、Smad-7水平。

关键词: 5-氟尿嘧啶, 肿瘤标志物, 结直肠癌, 奥沙利铂, 免疫功能

Abstract: Objective：To explore the clinical value of 5-fluorouracil combined with oxaliplatin in the treatment of colorectal cancer patients and its effects on tumor markers，immune function and serum transforming growth factor (TGF)-β1， matrix metalloproteinase (MMP) -7 and Smad-7.Methods：A total of 120 patients with colorectal cancer admitted in our hospital from May 2019 to May 2022 were selected and randomly divided into the experimental group (n=60) and the control group (n=60). The patients of the control group were treated with 5-fluorouracil， and the patients of the experimental group were treated with 5-fluorouracil combined with oxaliplatin. The immune function， tumor markers， serum TGF-β1， MMP-7 and Smad-7 levels of the two groups of patients were compared before treatment and after 6 weeks of treatment.Results：The total effective rate of the experimental group after treatment with 5-fluorouracil combined with oxaliplatin was 76.67%， which was higher than the effective rate of the control group after treatment with 5-fluorouracil (58.33%) (P<0.05). After 6 weeks of treatment， the CD4+ level and the CD4+/CD8+ratio of patients in both groups increased， while the levels of CA153， CD8+， CA242 and CA19-9 decreased in both groups， and the increase range of CD4+level and CD4+/CD8+ ratio of patients in the experimental group were higher than those of the control group（P<0.05）， the decrease range of CA153， CD8+， CA242 and CA19-9 of patients in the experimental group were higher than those of the control group (P<0.05). After 6 weeks of treatment， the TGF-β1 and MMP-7 levels of patients in both groups decreased， while the Smad-7 level of patients in both groups increased， and the decrease range of TGF-β1 and MMP-7 levels of patients in the experimental group were higher than those of the control group（P<0.05）， the increase rnage of Smad-7 level of patients in the experimental group was higher than that of the control group (P<0.05).Conclusion：In the treatment of colorectal cancer， 5-fluorouracil combined with oxaliplatin has significant effects， which can help to improve immune function， reduce the level of tumor markers and regulate TGF-β1， MMP-7， Smad-7 level.

Key words: 5-fluorouracil, Tumor markers, Colorectal cancer, Oxaliplatin, Immun function

中图分类号:

惠瞳, 陈颖慧, 赵旭. 5-氟尿嘧啶联合奥沙利铂对结直肠癌患者肿瘤标志物、免疫功能及血清TGF-β1、MMP-7、Smad-7的影响#br#[J]. 中国医药导刊, 2023, 25(9): 937-941.

HUI Tong, CHEN Yinghui, ZHAO Xu. Effects of 5-fluorouracil Combined with Oxaliplatin on Tumor Markers， Immune Function and Serum TGF-β1， MMP-7 and Smad-7 of Colorectal Cancer Patients#br#[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(9): 937-941.

参考文献

[1]王丽，李芳，谷妮妮，等. 羟基红花黄色素A通过Akt/mTOR-自噬通路抑制结直肠癌细胞增殖迁移和化疗耐药[J]. 中国中药杂志，2023，48(2)：517-524.
[2]Zhang Y，Zhang F，Zhao L，et al. Long-term survival of a patient with microsatellite-stable refractory colorectal cancer with regorafenib and PD-1 inhibitor sintilimab： a case report and review of literature[J]. BMC Gastroenterol， 2021，21(1)：399.
[3]林依琳，王文波，王雅，等. MiR-223-3p通过靶向SORBS1增加结直肠癌细胞对5-氟尿嘧啶的耐药性[J]. 中南大学学报（医学版），2023，48(3)：356-368.
[4]王蓉荻，郭旭，徐孟. 敲低CTCF对5-氟尿嘧啶、顺铂耐药结直肠癌细胞恶性生物学行为的影响及其机制[J]. 山东医药，2023，63(1)：42-46.
[5]曹会茹，徐阳，王华德，等. 结直肠癌组织中CISD2的表达及其对5-氟尿嘧啶化疗敏感性的影响[J]. 中国医科大学学报，2022，51(5)：429-434.
[6]俞新燕，李曼，项丽萍，等. 结直肠癌患者奥沙利铂化疗致外周神经毒性单因素分析及其防治策略[J]. 中国基层医药，2023，30(1)：2-6.
[7]国家卫生计生委医政医管局；中华医学会肿瘤学分会. 中国结直肠癌诊疗规范（2015版）[J]. 中华胃肠外科杂志，2015，18(10)：961-973.
[8]冯奉仪. 实体瘤新的疗效评价标准(解读1.1版RECIST标准) [C]. //第三届中国肿瘤内科大会论文集，2009：123-125.
[9]Colloca GA， Venturino A， Guarneri D. Primary tumor resection in patients with unresectable colorectal cancer with synchronous metastases could improve the activity of poly-chemotherapy：a trial-level meta-analysis[J].Surg Oncol，2022，44：101820.
[10]Wensink E，Bond M，Kucukkose E， et al. A review of the sensitivity of metastatic colorectal cancer patients with deficient mismatch repair to standard-of-care chemotherapy and monoclonal antibodies， with recommendations for future research[J]. Cancer Treat Rev，2021，95：102174.
[11]周彤，王烁，胡帅航，等. 复方苦参注射液联合含奥沙利铂化疗方案治疗晚期结直肠癌临床疗效及安全性的Meta分析[J]. 海南医学院学报，2022，28(20)：1579-1589.
[12]陈岷，张远，边原，等. 结直肠癌患者UMPS酶基因多态性与氟尿嘧啶化疗敏感性及毒性相关性研究[J]. 医药导报，2022，41(6)：869-873.
[13]唐斌，丁俊，蒋叶平，等. 血清外泌体miR-17-92a表达水平与行结直肠癌根治术中注射5-氟尿嘧啶治疗的结直肠癌患者预后的关系[J]. 广西医学，2022，44(24)：2857-2860.
[14]张丽菊，姜晓明，陈昌贤，等. 长链非编码RNA-p21调控微小RNA-9/去乙酰化酶1信号通路逆转结直肠癌细胞奥沙利铂耐药性[J]. 昆明医科大学学报，2022，43(5)：27-32.
[15]周帅，贾国战，韩伟光，等. 血清G-CSF、ADPN在奥沙利铂联合卡培他滨治疗Ⅲ期结直肠癌患者术后辅助中的表达及其与肠道菌群失调的相关性[J]. 现代生物医学进展，2022，22(17)：3298-3302.
[16]刘月，李鑫，庞文倩，等. 黑树莓花青素联合奥沙利铂或喜树碱通过Akt信号通路协同增强结直肠癌化疗药物的治疗效果及作用机制研究[J]. 中草药，2022，53(16)：5044-5051.

快速检索引用检索图表检索高级检索