李日明 廖湘晖 吴丽娟 刘祥东

【摘要】 目的：探讨质子泵抑制剂联合XELOX辅助化疗治疗进展期结肠癌的效果。方法：选取2014年5月-2015年5月本院收治的进展期结肠癌患者80例，采用信封法将其分为对照组与观察组，每组40例。两组均进行手术治疗，对照组术后采用XELOX辅助化疗，观察组术后采用质子泵抑制剂联合XELOX辅助化疗。比较两组不同TNM分期及V-ATPase表达情况的1、3、5年无病生存率（DFS）。结果：观察组与对照组V-ATPase表达阳性率分别为67.5%与62.5%，两组比较差异无统计学意义（P>0.05）。两组中ⅡB期患者1、3、5年DFS比较，差异均无统计学意义（P>0.05）。观察组中Ⅲ期患者1、3年DFS高于对照组（P<0.05），而兩组Ⅲ期患者5年DFS比较，差异均无统计学意义（P>0.05）。观察组中V-ATPase表达阳性患者1、3年DFS均高于对照组（P<0.05）。结论：质子泵抑制剂联合XELOX辅助化疗可在一定程度上延长Ⅲ期结肠癌与V-ATPase阳性表达患者的术后无病生存期，提高结肠癌患者疗效，建议在临床上推广应用。

【关键词】 质子泵抑制剂 XELOX 结肠癌

[Abstract] Objective： To investigate the efficacy of proton pump inhibitors combined with XELOX adjuvant chemotherapy in the treatment of advanced colon cancer. Method： A total of 80 patients with advanced colon cancer in our hospital from May 2014 to May 2015 were selected. They were divided into control group and observation group by envelope method， 40 cases in each group. Two groups were given surgical treatment， the control group was treated with XELOX adjuvant chemotherapy， and the observation group was treated with proton pump inhibitor combined with XELOX adjuvant chemotherapy. The 1-year， 3-year and 5-year disease-free survival rates （DFS） were compared between the two groups in different TNM stages and V-ATPase expression. Result： The positive rate of V-ATPase expression in the observation group and the control group were 67.5% and 62.5%， respectively， and there was no significant difference between two groups （P>0.05）. There were no significant differences in 1-year， 3-yaer， 5-year DFS of stage ⅡB patients between the two groups （P>0.05）. 1-year and 3-year DFS of stage Ⅲ patients in the observation group were higher than those in the control group （P<0.05）， while there was no significant difference in 5-year DFS of stage Ⅲ patients between the two groups （P>0.05）. The 1-yaer and 3-year DFS of patients with positive expression of V-ATPase in the observation group were higher than those in the control group （P<0.05）. Conclusion： Proton pump inhibitors combined XELOX adjuvant chemotherapy can prolong the disease-free survival of patients with stage Ⅲ colon cancer and V-ATPase positive expression to a certain extent， and improve the curative effect of patients with colon cancer. It is suggested to be popularized and applied in clinic.

[Key words] Proton pump inhibitor XELOX Colon cancer

First-authors address： Peoples Hospital of Suixi County， Suixi 524300， China

doi：10.3969/j.issn.1674-4985.2021.06.027

结肠癌是常见的消化系统恶性肿瘤，其治疗方式以外科手术为主。有研究表明，ⅡB期、Ⅲ期结肠癌患者术后具有较高复发、转移风险，而术后进行辅助化疗有利于减少复发[1]。有证据显示，使用XELOX方案对ⅡB期、Ⅲ期结肠癌术后进行辅助化疗的疗效确切[2-3]。近年来，研究发现肿瘤细胞耐药性对化疗效果造成较大影响。另有研究显示，肿瘤组织中液泡膜-ATP酶（V-ATPase）是调节肿瘤微环境的重要因子，而质子泵抑制剂（PPI）对V-ATPase表达有抑制作用[4-6]。然而目前鲜少关于结肠癌V-ATPase表达及PPI治疗效果的研究报道。本研究选取80例进展期结肠癌病例为研究对象，探讨质子泵抑制剂联合XELOX辅助化疗的应用价值，现报道如下。

1 资料与方法

1.1 一般资料 选取2014年5月-2015年5月本院收治的进展期结肠癌患者80例。纳入标准：在本院择期行结肠癌根治术，且术后经病理证实原发性结肠癌;术后行XELOX辅助化疗者;TNM分期为ⅡB、Ⅲ期;术前未接受过放疗、化疗或免疫治疗;预期生存期超过1年。排除标准……