目的 探讨新辅助放化疗对进展期胃癌的疗效及相关蛋白表达的影响.方法 选取80例进展期胃癌患者,随机数字表法分为两组,放化疗组患者(41例)术前采用SOX方案联合放射治疗,放疗者(39例)术前单纯给予放射治疗,观察并记录两组患者放化疗后的疗效、淋巴结阳性率、复发率和1年生存率、P53和MMP-2蛋白及放化疗期间不良反应情况.结果 放化疗组患者治疗有效率78.1%,放疗组患者治疗有效率59.0%,放化疗组治疗有效率明显高于放疗组(P<0.05).术后放化疗组淋巴结阳性率、复发率和1年生存率明显高于放疗组(P<0.05).新辅助放化疗前后,放化疗组患者体内P53和MMP-2蛋白表达水平变化较大,放化疗后P53和MMP-2蛋白表达阳性率明显低于放化疗前,治疗期间两组均发生了不同程度的不良反应.放化疗组恶心呕吐5例,4例骨髓抑制,3例肝功能损伤,3例白细胞数目下降,不良反应发生率为36.6%.放疗组恶心呕吐2例,1例骨髓抑制,1例白细胞数目下降,不良反应发生率为10.2%.结论 术前新辅助放化疗对进展期胃癌具有较好的疗效,能明显降低术后肿瘤复发率,提高患者生存率,但不良反应较多,临床应用时需根据患者身体情况酌情使用.%Objective To explore the efficacy of neoadjuvant chemotherapy for advanced gastric cancer and related pro -tein expression.Methods 80 patients with advanced gastric cancer were selected and divided into 2 groups with the random number table method.Before operation,chemoradiotherapy group(41 cases)were treated with sarbox combined with radiothera-py,and radiotherapy group(39 cases)were simply given radiotherapy.To observe and record the efficacy of the 2 groups of pa-tients after chemoradiotherapy,lymph node positive rate,recurrence rate and 1-year survival rate,P53 and mmp-2 protein and the adverse reactions during radiotherapy.Results The treatment effective rate of chemoradiotherapy group was 78.1%and 59.0%in the radiotherapy group.The treatment rate of chemoradiotherapy group was significantly higher than that of the radiotherapy group(P<0.05).The positive rate,recurrence rate and 1-year survival rate of postoperative chemoradiotherapy group were sig-nificantly higher than that of the radiotherapy group(P<0.05).Before and after neoadjuvant chemoradiation,radiation and chemotherapy patients P53 and MMP-2 protein expression level change was bigger,after concurrent chemoradiation,MMP-2 pro-tein expression and P53 positive positive significantly lower than the proportion of radiation and chemotherapy before,during the treatment,both groups had different degree of adverse reactions.There were 5 cases of nausea and vomiting,4 cases of bone mar-row suppression,3 cases of liver function injury,3 cases of leukocyte loss,and 36.6%of adverse reactions.There were 2 cases of nausea and vomiting in radiotherapy group,1 case of bone marrow suppression,1 case of leukocyte decreased,the incidence of ad-verse reactions was 10.2%,and the adverse reaction rate of radiotherapy group was less.Conclusion Preoperative neoadjuvant chemoradiation for advanced gastric cancer has good curative effect,can significantly reduce postoperative tumor recurrence rate and improve patients survival,but has more adverse reactions,clinical applications need to be used according to patients'body condition,as appropriate.
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