Study Of Anti-stomach Cancer Effects And Mechanism Of LTN Combined With Radiotherapy And Chemotherapy

Objective: Clinical observe the curative effect and toxic response by postoperative radiotherapy combined with chemotherapy and Lentinan in treatment of progressive stomach cancer. Research if the LTN have anti-tumor Activity and investigate it`s molecules effects. provide base for LTN combined combined with radiotherapy and chemotherapy in treatment of progressive stomach cancer.Methods: The study of clinical treatment: Postoperative patients began to therapy 3-4 weeks ago in therapeutic group. Chemotherapy: 5-FU 425mg/M2+CF 100-200mg dl-5 IVD. 28 days is a cycle. Radiotherapy: Reference operation and clear glandula lymphatica results. On the basis of the location of primary lesion, tumor and drained lymphatic district were selectively rayed by using 10mv x-ray. Radiation dose was DT4140CGY. Positive diseased zone add to DT5000-6000CGY. Immunotherapy:Lentinan 2mg/w×8w IVD. Chemotherapy was altered FOLFOX4 in 6 weeks after ending radiotherapy. The patients in control group that were operated 3-4weeks ago use FLOFOX4 in six cycles.Experimental study: 1. The MTT method decet that LTN makes impact on proliferation of human stomach cell line BGC-823, Effect of the LTN on the proliferation of mouse splenocytes. 2. The flow cytometry method detects that LTN makes impact on cell cycle and down-death of human stomach cell line BGC-823.3. Reverse transcriptase polymerase chain reaction (RT-PCR) detects LTN makes impact on apoptosis molecules (Bcl-2, Max) of stomach cell line BGC-823.4. Reverse tran-scriptase polymerase chain reaction (RT-PCR)detects LTN makes impact on immune-suppressive factor (VEGF, IL-10, TGF-β) of stomach cell line BGC-823.Results: Clinical observa-tion shows that: 60 patients completed therapy. The local control rates and survival rate in one year or two years were significant (X2=12, P<0.005; X2=4.8, P<0.05; X2=3.9, P<0.05). Bone marrow depression was not significant X2=5.26 P>0.05. Toxicity of digestive tract was significant in two groups X2=6.21 P<0.05. Toxicity of digestive tract was augmented in therapeutic group. But therapy didn't lead to interrupt. Late toxic reaction didn't occurred. Both groups didn't augmented operative toxic reaction. 60 patients completed therapy. The local control rates and survival rate in one year or two years were significant. Bone marrow depression was not significant X2=5.26 P>0.05. Toxicity of digestive tract was significant in two groups X2=6.21 P<0.05. Toxicity of digestive tract was augmented in therapeutic group. But therapy didn't lead to interrupt. Late toxic reaction didn't occurred. Both groups didn't augmented operative toxic reaction.Experimental observation shows that: 1. A certain concentration LTN can inhibit BGC-823 cell proliferation (P<0.01). a certain centration LTN can make BGC-823 appptosis increased;after using LTN the percentage of apoptosis cell is 4.84%. the expression of Bcl-2 in BGC-823 was remarkably decreased. The expression of Bax in BGC-823 was remarkably increased. A certain concentration LTN can proliferate mouse spleen cells (P<0.05). after using a certain concentration LTN, it can reduce expression of VEGF, TGF-βmRNA; But for IL-10 mRNA expression doesn`t downward obviously.Conclusion: The studies indicated that postopera-tive radiotherapy combined with chemotherapy and Lentinan was more therapeutical method in treatment of progressive stomach cancer and tolerated adverse reaction. LTN can inhibit cancer cell proliferation; LTN can adjust apoptosis factor mRNA expression and promote it apoptosis; LTN can play a role in immune regulation through the promotion of immunization cell and down-regulation of immunosuppressive factor mRNA`s expression. provide base for LTN in the function of anti-tumor and immmmunization and adjustment. Provide a method for LTN combined with postoperative radiotherapy and chemotherapy in treatment of progressive stomach cancer.