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目的 观察沙培林联合羟基喜树碱腹腔内给药治疗胃癌术后癌性腹水近期临床疗效及有关机制。方法 2 0 0 0 - 0 6～ 2 0 0 3- 0 5南京军区福州总医院对 6 0例胃癌术后癌性腹水患者采用腹腔穿刺抽液 ,并随机分成两组。腹腔免疫化疗组采用腹腔注射沙培林联合羟基喜树碱治疗 (30例 ) ;单纯化疗组单用羟基喜树碱治疗 (30例 )。B超测定患者治疗前后腹水消退率。结果 腹腔免疫化疗组一疗程有效率 90 % ,其中CR 11例 (37% ) ,PR16例 (5 3% ) ;单纯化疗组有效率 6 7% ,其中CR8例 (2 7% ) ,PR 12例 (40 % )。腹腔免疫化疗组显著降低外周血中消化道相关抗原 (CCA)和可溶性白介素受体 (sIL 2R)含量 ,T淋巴细胞核仁形成区嗜银蛋白 (Ag NORs)含量也稍有降低 ;其退腹水有效率高于单纯化疗组。结论 沙培林联合羟基喜树碱具有协同抗癌作用 ,两者合用是治疗胃癌患者术后癌性腹水安全、简便的有效方法。
Objective To observe the recent clinical efficacy and related mechanisms of the combination of Sapylin and hydroxycamptothecine in the treatment of postoperative malignant ascites due to gastric cancer. Methods 2 0 0 0 0 6 0 0 0 0 0 0 0 0 5 Nanjing Military Region, Fuzhou General Hospital of 60 cases of patients with postoperative ascites cancerous ascites by abdominal paracentesis and randomized into two groups. The intraperitoneal immunochemotherapy group was treated by intraperitoneal injection of saponin combined with hydroxycamptothecin (30 cases); the simple chemotherapy group was treated with hydroxycamptothecin alone (30 cases). B ultrasound measured before and after treatment in patients with ascites rate. Results The effective rate of intraperitoneal immunotherapy was 90% in one group, of which 11 (37%) were CR and 16 (53%) were PR. The effective rate was 67% in CR group (27%) and PR (40%). The intraperitoneal immunochemotherapy group significantly decreased the content of digestive tract related antigen (CCA) and soluble interleukin receptor (sIL 2R) in the peripheral blood and slightly decreased the content of Ag NORs in the T lymphocyte nuclei; Efficiency is higher than chemotherapy group. Conclusion Sapirin combined with hydroxycamptothecin has a synergistic anticancer effect, and the combination of both is an effective and safe method for the treatment of postoperative cancerous ascites in patients with gastric cancer.