ABSTRACT
Objective:To investigate the correlation between the expressions of miR-524-5p and sex determining region Y box protein 9 (SOX9) in advanced gastric cancer and their influences on the efficacy and prognosis of chemotherapy.Methods:A total of 82 patients diagnosed as advanced gastric cancer who received DCF (docetaxel + cisplatin + fluorouracil) chemotherapy in 910th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army from January 2015 to December 2017 were selected as the research objects. The expression levels of miR-524-5p and SOX9 in gastric cancer tissues were detected by fluorescence quantitative PCR. The correlation between the expressions of miR-524-5p and SOX9 was analyzed, the total effective rates of chemotherapy in patients with different miR-524-5p and SOX9 expression levels were compared, and the predictive value of miR-524-5p combined with SOX9 on the efficacy of chemotherapy was analyzed. Overall survival (OS) and progression-free survival (PFS) were analyzed.Results:The expressions of miR-524-5p and SOX9 were not related to gender or age of patients with advanced gastric cancer (all P>0.05), but were related to the degree of differentiation ( χ2=3.577, P=0.001; χ2=5.654, P<0.001) and distant metastasis ( χ2=2.466, P=0.016; χ2=5.218, P<0.001) of patients with advanced gastric cancer. There was a negative correlation between the expressions of miR-524-5p and SOX9 in advanced gastric cancer ( r=-0.348, P=0.001). According to the median expressions of miR-524-5p and SOX9 in gastric cancer tissues, patients were divided into high expression and low expression groups, miR-524-5p≥0.64 was high expression ( n=41), <0.64 was low expression ( n=41), SOX9≥1.84 was high expression ( n=41), and <1.84 was low expression ( n=41). The total effective rate of advanced gastric cancer patients with high expression of miR-524-5p was 58.54% (24/41), which was higher than that of patients with low expression of miR-524-5p (24.39%, 10/41), and there was a statistically significant difference ( χ2=9.484, P=0.002). The total effective rate of advanced gastric cancer patients with high expression of SOX9 was 21.95% (9/41), which was lower than 60.97% (25/41) of patients with low expression of SOX9, and there was a statistically significant difference ( χ2=12.863, P<0.001). Receiver operating characteristic curve analysis showed that the expressions of miR-524-5p and SOX9 had predictive value for the efficacy of chemotherapy, and the area under the curve was 0.753 (95% CI: 0.644-0.861, P<0.001) and 0.660 (95% CI: 0.540-0.780, P=0.014) respectively. The combination of miR-524-5p and SOX9 had predictive value for the efficacy of chemotherapy, and the area under the curve was 0.768 (95% CI: 0.667-0.868, P<0.001). The median PFS and OS of patients with high expression of miR-524-5p were 8 months and 14 months, which were longer than those of patients with low expression of miR-524-5p (6 months, 9 months), and there were statistically significant differences ( χ2=21.160, P<0.001; χ2=29.730, P<0.001). The median PFS and OS of patients with high expression of SOX9 were 7 months and 10 months, which were shorter than those of patients with low expression of SOX9 (8 months, 12 months), and there were statistically significant differences ( χ2=6.345, P=0.012; χ2=4.107, P=0.043). Conclusion:There is a negative correlation between the expressions of miR-524-5p and SOX9 in advanced gastric cancer tissues. The chemotherapy efficacy and prognosis of patients with high expression of miR-524-5p and low expression of SOX9 are better than those of patients with low expression of miR-524-5p and high expression of SOX9.
ABSTRACT
Objective To investigate the effects of Dingkoulizhong decoction on cellular immune factors and adverse reactions in patients with advanced gastric cancer treated with chemotherapy.Methods One hundred and thirty-eight patients with advanced gastric cancer were enrolled in our hospital from October 2014to December 2016,and were randomly divided into control group (n =69) and observation group (n =69) by using the random number table.The patients of the control group were treated with FOLFOX4 chemotherapy (oxaliplatin + calcium folinate + fluorouracil),while the patients of the observation group were given by the treatment of Dingkoulizhong decoction on the basis of the control group.The peripheral blood samples of the patients were collected before and after the treatment.The levels of cellular immune factors CD3 +,CD4 +,CD8 + and CD4 +/CD8 + were detected,and the clinical efficacy and adverse reactions of the patients of the two groups were observed.Results After the treatment,the number of complete remission (CR),partial remission (PR),stable disease (SD) and progressive disease (PD) in the observation group were 16,25,16 and 12 cases respectively,while the control group were 9,20,19 and 21 cases respectively,and there was a statistically significant difference in the distribution of clinical efficacy between the two groups (Z =4.381,P =0.036).Compared with the control group,the clinical benefit rate (CBR) of the observation group was significantly improved (59.42％ vs.42.03％),with a statistically significant difference (x2 =4.175,P =0.041).The cellular immune factors CD3 + [(52.67 ±6.21)％ vs.(53.45 ±6.54)％],CD4 + [(23.56 ±3.85)％ vs.(24.09±2.91)％],CD8 +[(28.16±3.49)％ vs.(27.87±3.26)％] and CD4 +/CD8+(1.13 ± 0.27 vs.1.19 ±± 0.31) of the patients of the observation group showed no statistically significant difference (t=0.718,P=0.474;t=0.912,P=0.363;t=0.504,P=0.615;t=1.212,P=0.227) beforeand after the treatment,but the cellular immune factor CD3 + [(50.36 ± 3.74)％ vs.(53.13 ± 6.12)％],CD4 +[(21.26±2.37)％ vs.(23.44 ±3.96)％] andCD4+/CD8*(0.96±0.26vs.1.15±0.25) of the patients of the control group after the treatment were significantly lower than those before the treatment,and CD8 +[(31.64 ± 4.05) ％ vs.(27.98 ± 3.52) ％] after the treatment was significantly higher than that before the treatment,all with statistically significant differences (t =3.208,P ＜ 0.001;t =3.924,P ＜ 0.001;t =4.289P ＜ 0.001,t =5.666,P ＜ 0.001).Compared with the control group,the level of CD3 + [(53.45 ± 6.54) ％ vs.(50.36±±3.74)％],CD4+[(24.09±±2.91)％ vs.(21.26±2.37)％] andCD4+/CD8+(1.19±0.31vs.0.96 ± 0.26) of the patients of the observation group after the treatment were significantly improved,and CD8 +[(27.87 ± 3.26) ％ vs.(31.64 ± 4.05) ％] was significantly decreased,all with statistically significant differences (t=3.407,P=0.001;t =6.264,P＜0.001;t =4.722,P＜0.001;t =6.023,P＜0.001).Compared with the control group,the total adverse reaction rate of the observation group was significantly decreased (36.23％ vs.55.07％),with a statistically significant difference (x2 =4.936,P =0.026).Conclusion Dingkoulizhong decoction can significantly improve the clinical efficacy in patients with advanced gastric cancer treated with chemotherapy,alleviate the immune function damage caused by chemotherapy,and it can reduce the occurrence of adverse reactions.