目的

研究西咪替丁预防大肠癌复发转移临床疗效以及与唾液酸化Lewis X（SLeX）蛋白表达的关系。

方法

应用微波-链霉菌素-生物素（微波-LSAB）法检测80例大肠癌SLeX蛋白表达水平。将阳性表达的73例随机分为两组：西咪替丁治疗组43例，对照组30例。手术后第3周开始，对Duke's A期和B期患者，治疗组每天口服氟尿嘧啶200 mg和西咪替丁800 mg；对照组仅每天口服氟尿嘧啶200 mg。对Duke's C期患者，两组均采用LFP方案化疗，同时，分别采取上述方法对照治疗。服药时间均为1年。平均随访时间为（10.4±2.6）年。

结果

治疗组与对照组比较，10年总体生存率分别为83.7%和50.0%，Duke's C 期生存率分别为84.6%和22.2%，SLeX蛋白表达III级生存率分别为92.3%和29.4%，肝脏转移率分别为20.9%和53.3%，上述差异均有统计学意义（P＜0.05）；Duke's A+B期生存率分别为82.4%和91.7%，SLeX蛋白表达II级生存率分别为70.6%和76.9%，局部复发率分别为25.6%和43.3%，上述差异均无统计学意义。

结论

西咪替丁对SLeX蛋白高水平表达的中晚期大肠癌有一定的抗转移治疗作用，有助于降低转移率，延长患者生存期，提高生存率。

Objective

To investigate the clinical effects of cimetidine for the treatment of colorectal cancer and the relationships with the expression of sialyl Lewis-X (SLeX) in colorectal carcinoma.

Methods

The expressions of SLeX in colorectal carcinoma (80 cases)were studied by microwave-labelled strept-avidin biotin immunohistochemical method.Seventy-three patients with positive expressions of SLeX were randomly allocated into two groups.The cimetidine group (43 cases)was given 200 mg per day of 5-fluorouracil orally together with 800 mg per day of cimetidine,while the control group (30 cases)received 5-fluorouracil alone.The treatment was initiated 3 weeks after the operation and terminated after one year for all patients.LFP chemotherapy was administrated for Duke's C patients.A mean follow-up term was (10.4±2.6)years.

Results

The total 10-year survival rate in cimetidine group was 83.7%,whereas that in control group was 50.0%.The 10-year survival rate of Duke's C patients in cimetidine group was 84.6%,whereas that in control group was 22.2%.The 10-year survival rate of patients with high SLeX expression (grade III)in cimetidine group was 92.3%,whereas that in control group was 29.4%.Hepatic metastasis in cimetidine group was 20.9%,whereas that in control group was 53.3%.The effects of cimetidine treatment as shown above parameters was remarkably significant (P＜0.05). In contrast, the 10-year survival rate of Duke's A+B patients in cimetidine group was 82.4%, whereas that in control group was 91.7%.The 10-year survival rate of patients with low SLeX expression (grade Ⅱ)in cimetidine group was 70.6%,whereas that in control group was 76.9%.Local recurrence in cimetidine group was 25.6%,whereas that in control group was 43.3%.The effects of cimetidine treatment as shown above parameters was not significant.

Conclusion

Cimetidine administration can dramatically improve patients'survival rate in advanced colorectal cancer patients with tumor cells ofhigh expressing levels ofSLeX.