中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
Chinese Journal of General Surgery
2015年
8期
650-653
,共4页
赵加应%蔡元坤%殷琛庆%沈晨霞%陈骏%李小静%舒维清
趙加應%蔡元坤%慇琛慶%瀋晨霞%陳駿%李小靜%舒維清
조가응%채원곤%은침경%침신하%진준%리소정%서유청
结肠肿瘤%抗肿瘤联合化疗方案%奥美拉唑%无病生存
結腸腫瘤%抗腫瘤聯閤化療方案%奧美拉唑%無病生存
결장종류%항종류연합화료방안%오미랍서%무병생존
Colonic neoplasms%Antineoplastic combined chemotherapy protocols%Omeprazole%Disease-free survival
目的 探讨质子泵抑制剂(PPI)奥美拉唑联合FOLFOX方案应用于Ⅱ、Ⅲ期结肠癌根治术后辅助化疗的疗效.方法 研究2008-2009年上海市第五人民医院收治的Ⅱ、Ⅲ期结肠癌患者,将符合入组标准的98例患者随机分为研究组(48例)和对照组(50例),均先行结肠癌根治术,术后标本进行常规病理检测和免疫组化检测V-ATPase蛋白的表达情况.研究组应用奥美拉唑联合FOLFOX方案化疗,对照组应用FOLFOX方案化疗,化疗期限为6个月,行8～12个疗程,随访疗效.结果采用统计学分析,比较两组化疗不良反应和术后2、3和5年无病生存率(disease-free survival,DFS)的差异.结果 93例完成研究,5例失访,两组患者基线资料分布基本平衡,研究组化疗的胃肠道反应不良反应低于对照组(x2 =4.924 6,P=0.026).两组患者总体术后2、3和5年DFS分别为73％比60％ (x2=1.743 7,P=0.187)、62％比50％(x2=1.407 5,P=0.235)、49％比40％(x2 =0.815 9,P=0.366),差异均无统计学意义(均P＞0.05).结肠癌组织中V-ATPase蛋白阳性表达率为71％(70/98),V-ATPase蛋白阳性表达患者中研究组和对照组术后2、3年DFS分别为75％比51％(x2=3.970 8,P=0.046)、66％比40％(x2 =4.399 5,P=0.036),与对照组相比,研究组术后2年和3年DFS提高,差异均有统计学意义(P＜0.05);Ⅲ期结肠癌患者中研究组和对照组术后2年DFS分别为73％比47％ (x2 =4.504 5,P=0.034),与对照组相比,研究组术后2年DFS提高,差异有统计学意义(P＜0.05).结论 PPI联合FOLFOX方案应用于V-ATPase蛋白阳性表达结肠癌患者或Ⅲ期结肠癌患者术后辅助化疗可改善疗效,降低化疗胃肠道不良反应.
目的 探討質子泵抑製劑(PPI)奧美拉唑聯閤FOLFOX方案應用于Ⅱ、Ⅲ期結腸癌根治術後輔助化療的療效.方法 研究2008-2009年上海市第五人民醫院收治的Ⅱ、Ⅲ期結腸癌患者,將符閤入組標準的98例患者隨機分為研究組(48例)和對照組(50例),均先行結腸癌根治術,術後標本進行常規病理檢測和免疫組化檢測V-ATPase蛋白的錶達情況.研究組應用奧美拉唑聯閤FOLFOX方案化療,對照組應用FOLFOX方案化療,化療期限為6箇月,行8～12箇療程,隨訪療效.結果採用統計學分析,比較兩組化療不良反應和術後2、3和5年無病生存率(disease-free survival,DFS)的差異.結果 93例完成研究,5例失訪,兩組患者基線資料分佈基本平衡,研究組化療的胃腸道反應不良反應低于對照組(x2 =4.924 6,P=0.026).兩組患者總體術後2、3和5年DFS分彆為73％比60％ (x2=1.743 7,P=0.187)、62％比50％(x2=1.407 5,P=0.235)、49％比40％(x2 =0.815 9,P=0.366),差異均無統計學意義(均P＞0.05).結腸癌組織中V-ATPase蛋白暘性錶達率為71％(70/98),V-ATPase蛋白暘性錶達患者中研究組和對照組術後2、3年DFS分彆為75％比51％(x2=3.970 8,P=0.046)、66％比40％(x2 =4.399 5,P=0.036),與對照組相比,研究組術後2年和3年DFS提高,差異均有統計學意義(P＜0.05);Ⅲ期結腸癌患者中研究組和對照組術後2年DFS分彆為73％比47％ (x2 =4.504 5,P=0.034),與對照組相比,研究組術後2年DFS提高,差異有統計學意義(P＜0.05).結論 PPI聯閤FOLFOX方案應用于V-ATPase蛋白暘性錶達結腸癌患者或Ⅲ期結腸癌患者術後輔助化療可改善療效,降低化療胃腸道不良反應.
목적 탐토질자빙억제제(PPI)오미랍서연합FOLFOX방안응용우Ⅱ、Ⅲ기결장암근치술후보조화료적료효.방법 연구2008-2009년상해시제오인민의원수치적Ⅱ、Ⅲ기결장암환자,장부합입조표준적98례환자수궤분위연구조(48례)화대조조(50례),균선행결장암근치술,술후표본진행상규병리검측화면역조화검측V-ATPase단백적표체정황.연구조응용오미랍서연합FOLFOX방안화료,대조조응용FOLFOX방안화료,화료기한위6개월,행8～12개료정,수방료효.결과채용통계학분석,비교량조화료불량반응화술후2、3화5년무병생존솔(disease-free survival,DFS)적차이.결과 93례완성연구,5례실방,량조환자기선자료분포기본평형,연구조화료적위장도반응불량반응저우대조조(x2 =4.924 6,P=0.026).량조환자총체술후2、3화5년DFS분별위73％비60％ (x2=1.743 7,P=0.187)、62％비50％(x2=1.407 5,P=0.235)、49％비40％(x2 =0.815 9,P=0.366),차이균무통계학의의(균P＞0.05).결장암조직중V-ATPase단백양성표체솔위71％(70/98),V-ATPase단백양성표체환자중연구조화대조조술후2、3년DFS분별위75％비51％(x2=3.970 8,P=0.046)、66％비40％(x2 =4.399 5,P=0.036),여대조조상비,연구조술후2년화3년DFS제고,차이균유통계학의의(P＜0.05);Ⅲ기결장암환자중연구조화대조조술후2년DFS분별위73％비47％ (x2 =4.504 5,P=0.034),여대조조상비,연구조술후2년DFS제고,차이유통계학의의(P＜0.05).결론 PPI연합FOLFOX방안응용우V-ATPase단백양성표체결장암환자혹Ⅲ기결장암환자술후보조화료가개선료효,강저화료위장도불량반응.
Objective To investigate the effect of omeprazole combined with FOLFOX scheme as an adjuvant therapy for stage Ⅱ or Ⅲ colon cancer patients after a radical resection.Methods 98 stage Ⅱ or Ⅲ colon cancer patients in our hospital from January 2008 to December 2009 were randomly divided into study group (48 cases) receiving regimen of omeprazole combined with FOLFOX and control group (50 cases) treated with FOLFOX chemotherapy after radical colectomy.Surgical specimens were examined for expression of V-ATPase protein.Chemotherapy period was 6 months,8-12 courses.We observed results of follow-up curative effect,comparing the side effects and postoperative 2 year,3 year and 5 year disease-free survival rate (DFS) difference using statistical analysis.Results Study was completed in all 93 cases,5 cases were lost to follow-up.The baseline data distribution in the two groups were balanced basically.In study group the gastrointestinal side effects of chemotherapy was lower than the control group (x2 =4.924 6,P =0.026).In the two groups,the 2-year,3-year and 5-year DFS were 73％ vs 60％ (x2 =1.743 7,P =0.187),62％ vs50％ (x2 =1.4075,P=0.235),49％ vs40％ (x2 =0.8159,P=0.366) (P＞0.05).V-ATPase protein expression was 71％ (70/98) in all samples.The 2-year and 3-year DFS of patients for V-ATPase protein positive expression in the two groups were 75％ vs 51％ (x2 =3.970 8,P =0.046),66％ vs 40％ (x2 =4.399 5,P =0.036).Compared with the control group,the 2-year,3-year DFS increased in the study group (P ＜ 0.05).In stage Ⅲ colon cancer patients,the 2-year DFS was 73％ vs 47％ (x2 =4.504 5,P =0.034).Conclusions PPI combined with FOLFOX in V-ATPase protein positive expression or Ⅲ stage colon cancer patients after radical colectemy improves long-term survival,as well as reduces the gastrointestinal side effects of chemotherapy.
