| Objective:To observe the clinical efficacy and safety of apatinib mesylate in treating gastric cancer with liver metastases,and to observe its effects on tumor indexes CA125 and CA19-9 and related biochemical indexes after treatment.Methods:A retrospective analysis was performed on 76 gastric cancer patients with liver metastases who had complete clinical data in Zhenjiang First People’s Hospital from February 2017 to May 2020.The patients were divided into an experimental group(n=38)and a control group(n=38)according to whether they took apatinib.Patients in the experimental group were treated with chemotherapy in combination with apatinib at a dose starting from 250 mg,and the drug dose was adjusted later according to the disease condition.Patients in the control group were treated with chemotherapy only.After 2 courses of treatment,the patients were classified into complete remission(CR),partial remission(PR),stable disease(SD),and disease progression(PD)according to the RECIST 1.1 assessment criteria,and the objective control rate(ORR)and disease control rate(DCR)were calculated.Survival analysis was performed using the Kaplan-Meier method to compare the m PFS and m OS of the two groups.At the same time,the occurrence of adverse effects,tumor indexes,and related biochemical markers in serum before and after treatment was compared between the two groups.Results:In the experimental group,there were 16 cases of PR,13 cases of SD,and 9 cases of PD.The ORR was 42.1%,and the DCR was 77.5%.In the control group,there were 10 cases of PR,10 cases of SD,and 18 cases of PD.The ORR was 26.3%,and the DCR was 52.6%.The disease control rate of the experimental group was significantly higher than that of the control group,which was statistically significant(P=0.021).The m PFS and m OS of the experimental group were 5.4 months and 10.7 months,respectively,while the m PFS and m OS of the control group were 2.8 months and 8.4 months,respectively.The progression-free survival time and overall survival time of the patients in the experimental group were longer than those in the control group,and the difference was statistically significant(P=0.021).After treatment,the serum levels of CA125 and CA19-9 in the experimental group were lower than those before treatment,but there was no significant change in CEA and AFP.The serum CA125 in the control group was lower than that before treatment.The common adverse effects included fatigue,diarrhea,hypertension,hand-foot syndrome,proteinuria,leukopenia,anemia,and thrombocytopenia.The incidence of hypertension in the experimental group was higher than that in the control group,and the incidence of leukopenia in the control group was higher than that in the control group.Conclusion:The effect of apatinib combined with chemotherapy in the treatment of liver metastases from gastric cancer is better than that of chemotherapy alone,which can significantly improve ORR and DCR,prolong m PFS and OS of patients,and its adverse reactions are controllable.After 2courses of treatment,the levels of serum CA125 and CA19-9 were significantly lower than those before treatment,while AFP had no significant change.Objective:Pyroptosis-related Lnc RNA was screened out by bioinformatics to predict the prognosis and immune infiltration of patients with gastric cancer.Methods:The RNA-seq data and clinicopathological information of 32 standard samples and 375 samples of gastric cancer were downloaded from The Tumor Genome Atlas(TCGA)database,and pyroptosis-related genes were screened in the NCBI database.The co-expressed lnc RNAs in gastric cancer and pyroptosis-related genes were screened by Pearson correlation analysis and further screened by univariate COX regression analysis,and 19 pyroptosis-related lnc RNAs were found to have prognostic value for gastric cancer patients.Lasso regression and multivariate Cox regression were used to further screen out 9 lnc RNAs which were significantly associated with prognosis.Based on the selected lnc RNAs,a risk model of lnc RNAs related to gastric cancer pyroptosis was established,and the risk scores of all patients were calculated.According to the model’s median score,gastric cancer patients were divided into high-risk and low-risk groups.Kaplan-Meier analysis was used to estimate the difference in survival between the two groups.The prognostic characteristics of gastric cancer were constructed by the least absolute shrinkage and selection operator(LASSO)and Cox regression,At the same time,GO enrichment analysis and KEGG analysis were used to analyze the expression of immune cells and the activity of immune-related pathways in the two groups of patients.Results:Nine gastric cancer pyroptosis-related lnc RNAs can predict OS in gastric cancer patients.Based on 9 lnc RNAs,a risk model associated with pyroptosis was established,which can predict the survival time and prognosis of patients.Combined with other features,it was found that pyroptosis-related lnc RNAs were independent prognostic factors in gastric cancer patients.Furthermore,we found that the expression of immune cells and the activity of immune-related pathways in the high-risk group were higher than those in the low-risk group,indicating that the high-risk group was more sensitive to immunotherapy.Conclusion:This risk model based on the 9 gastric cancer pyroptosis-related lnc RNAs may be promising for the clinical prediction of prognosis and immunotherapeutic responses in gastric cancer patients. |
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