目的 探讨曲妥珠单抗用于人表皮生长因子受体(HER2)阳性胃癌治疗的疗效及对患者血清肿瘤标志物的影响.方法 前瞻性入组HER2阳性胃癌患者80例,随机分为观察组(40例)和对照组(40例).对照组给予顺铂+卡培他滨化疗;在此治疗方案基础上,观察组于化疗第1天加用曲妥珠单抗静脉滴注,8 mg/kg.21 d为1个周期,2组均治疗6个周期.比较2组患者的临床疗效、血清肿瘤标志物水平和不良反应发生情况.结果 治疗6个周期后,观察组总有效率为55.0%,对照组总有效率为32.5%,2组差异有统计学意义(P<0.05);观察组患者的血清癌胚抗原(CEA)、单核细胞趋化因子(MCP-1)等水平均显著低于对照组,差异均有统计学意义(P<0.05).2组患者的恶心呕吐、肝功能损害等不良反应发生率均无统计学差异(P>0.05).结论 曲妥珠单抗具有较好的抗肿瘤效果,可改善HER2阳性胃癌患者的临床疗效,其机制可能与抑制IL-1β、上调MCP-1的表达有关.
Objective To investigate the efficacy of trastuzumab for human epidermal growth factor receptor ( HER2 ) positive gastric cancer patients and its effect on serum tumor markers. Methods 80 patients with HER2-positive gastric cancer were randomly divided into the observation group ( n=40 ) and the control group ( n=40 ) . The control group was treated with cisplatin+capecitabine. On the basis of the control group,the observation group was treated with 8 mg/kg trastuzumab on the first day after chemotherapy. 21 days for a course of treatment,both groups were treated for 6 courses. The clinical efficacy,level of ser-um tumor markers and adverse reaction were compared between the 2 groups. Results After 4 courses treatment,the total effec-tive rate was 55. 0% in the observation group and 32. 5% in the control group. The total effective rate between the 2 groups was significantly different (P<0. 05);the level of serum CEA and MCP-1 in the observation group were significantly lower than the control group (P<0. 05). There was no significant difference between the 2 groups in the incidence of nausea,vomiting and liver injury (P>0. 05). Conclusion Trastuzumab has a good anti-tumor effect,which can improve the clinical efficacy of patients with HER2-positive gastric cancer,the mechanism may associate with inhibiting IL-1β and upregulation of MCP-1.