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背景:奥曲肽是一种体外合成的生长抑素类似物,其对肿瘤细胞的抑制作用越来越受到人们的关注。新生血管形成对肿瘤的生长和转移起重要作用。许多抗新生血管形成的治疗已经引入临床试验,生长抑素类似物可用作抗新生血管形成的治疗。目的:评价奧曲肽治疗晚期消化道肿瘤的临床受益反应(CBR)及其对患者血清胰岛素样生长因子(IGF)-Ⅰ水平的影响,探讨奥曲肽的抗肿瘤作用机制。方法:予28例晚期消化道肿瘤患者奥曲肽0.2mg。每12h皮下注射1次,直至病情进展或不能耐受治疗为止,综合评估CBR;采用双抗体夹心酶联免疫吸附测定(ELISA)检测治疗前和治疗1个月后的血清IGF-Ⅰ水平。结果:奥曲肽治疗的总体CBR率为60.7％(17/28);治疗1个月后,患者血清IGF-Ⅰ水平(54.8ng/L±27.4ng/L)较治疗前(183.1ng/L±56.6ng/L)显著下降(P<0.01),其中19例(67.9％)患者为明显下降。结论:奥曲肽能显著降低晚期消化道肿瘤患者血清IGF-Ⅰ水平,抑制肿瘤生长,使患者获得较高的CBR率。
BACKGROUND: Octreotide is an in vitro synthesized somatostatin analogue, and its inhibitory effect on tumor cells has attracted more and more attention. Neovascularization plays an important role in tumor growth and metastasis. Many antiangiogenic therapies have been introduced into clinical trials, and somatostatin analogs can be used as anti-angiogenic therapies. OBJECTIVE: To evaluate the clinical benefit response (CBR) of octreotide in treatment of advanced gastrointestinal neoplasms and its effect on the level of serum insulin-like growth factor (IGF-I) in patients with advanced gastric cancer, and to explore the antitumor mechanism of octreotide. Methods: 28 patients with advanced gastrointestinal cancer patients with octreotide 0.2mg. The patients were injected subcutaneously once every 12 hours until the disease progressed or could not be tolerated. CBR was assessed comprehensively. Serum IGF-Ⅰ levels were measured before and after treatment for 1 month by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Results: The overall CBR rate of octreotide treatment was 60.7% (17/28). After 1 month of treatment, the level of serum IGF-Ⅰ (54.8ng / L ± 27.4ng / L) was significantly higher than that before treatment (183.1ng / L ± 56.6 ng / L) (P <0.01), of which 19 (67.9%) patients were significantly decreased. Conclusion: Octreotide can significantly reduce the level of serum IGF-Ⅰ in patients with advanced gastrointestinal cancer, inhibit the growth of the tumor and make the patients get higher CBR rate.