| Objective:To study the correlation between preoperative and postoperative hematological parameters including blood lipid level,tumor markers,and the changes of body weight and postoperative histopathological response in patients with locally advanced gastric cancer.Preliminary study on related factors of predicting the efficacy of preoperative chemotherapy for gastric cancer.Methods:50 patients with gastric adenocarcinoma who had been treated by in the Second Affiliated Hospital of Zhejiang University from May 2013 to May 2016 were analyzed retrospectively,which were confirmed by pathology and were treated by MDT in our hospital.All received 21 days a cycle of chemotherapy.The process of conventional chemotherapy use the same type of unified auxiliary protecting stomach,antiemetic and leukogenic drugs.The process of conventional chemotherapy use the same type of unified auxiliary protecting stomach,antiemetic and leukogenic drugs.Before the start of chemotherapy,blood parameters,blood lipids,D-two dimmer and tumor markers were detected;and serum tumor markers were reviewed after 3 cycles of chemotherapy.The body weight was recorded before and after the end of the 3 chemotherapy cycle(before operation);After 3 courses of chemotherapy,all operations were performed;Routine pathological examination after operation.The histopathological response after chemotherapy was based on Becker score.SPSS 13 software was used for statistical analysis.The changes of body weight,blood routine,blood lipid,D-two dimmer and tumor markers were tested by chi square test;The relationship between pathological response and clinical pathological data was analyzed by chi square test or Fisher exact probability method;Multivariate regression analysis was used to analyze the factors influencing the pathological response;Statistical analysis of continuous variables using t test and variance analysis;The relationship between the changes of body weight,blood routine,blood lipid,D-two dimmer,tumor markers,and the pathological changes were analyzed.P<0.05 as a statistically significant difference.Results:Retrospective analysis founds Weight gain>3%in 26 cases,There were 14 cases of pathological reaction,no pathological reaction in 12 cases;Weight gain(including reduced)>3%in 24 cases,of which 4 cases of pathological reaction,no pathological reaction in 20 cases.There was statistical difference between the two(P=0.035).The results showed that there was a correlation between the increase of body weight and pathological changes after chemotherapy.Before chemotherapy blood indexes(neutrophil,platelet ratio,lymph lymph than low density lipoprotein,high density lipoprotein,total cholesterol,D two dimmer,serum CEA,serum CA19-9,serum CA-125),By comparing the histopathological response after chemotherapy,the difference was not statistically significant.(P>0.05)The level of serum CEA was significantly lower in patients with Becker's grade 2 and grade 3 before chemotherapy and after chemotherapy,compared with grade 1,with statistical difference(1.88±1.53?1.65±1.12 vs 4.01±7.32);Compared with patients with Becker's grade 1 and grade 2,the serum CA19-9 ratio of patients with grade 3 was significantly decreased,and the difference was statistically significant(7.05 ± 10.75?7.60 ± 11.23 vs 1.87 ± 1.73);There was no significant difference in serum CA-125 ratio in each group(1.49 ± 0.85 vs 1.36 ± 0.92?1.64 ±1.19)?Conclusion:1.Weight gain(>3%)during chemotherapy may be an independent predictor of chemotherapy efficacy in patients with locally advanced gastric cancer undergoing preoperative chemotherapy.2.The decrease of serum CEA and CA19-9 levels before and after chemotherapy,which may be an effective index to predict the effectiveness of preoperative chemotherapy.The change of serum C A-125 has no predictive value. |
PDF Full Text Request