摘要目的:比较XELOX（奥沙利铂+卡培他滨）方案与FOLFOX4（奥沙利铂+亚叶酸钙+氟尿嘧啶）方案治疗结肠癌效果和对血清肿瘤标志物及细胞学指标的影响。方法:选取安徽省芜湖市中医院2016年1月至2019年1月收治的84例结肠癌患者，按照随机数字表法分为观察组（XELOX方案，42例）和对照组（FOLFOX4方案，42例）。比较两组患者疗效、不良反应及化疗前后血清肿瘤标志物与细胞学指标的变化。结果:观察组近期有效率为76.19%（32/42），对照组为61.91%（26/42），差异无统计学意义（χ 2=2.005， P=0.156）。观察组不良反应发生率为35.71%（15/42），低于对照组的59.53%（25/42）（χ 2=4.773， P=0.029）。两组治疗前糖类抗原19-9（CA19-9）、大肠癌特异性抗原2（CCSA-2）、骨桥素（OPN）水平比较，差异均无统计学意义（均 P>0.05）；两组治疗后CA19-9、CCSA-2、OPN水平较治疗前均降低（均 P<0.05）；治疗后观察组CA19-9、CCSA-2、OPN水平均低于对照组（均 P<0.05）。两组治疗前中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、红细胞分布宽度（RDW）比较，差异均无统计学意义（均 P>0.05）；两组治疗后NLR、PLR、RDW较治疗前均降低（均 P<0.05）；治疗后观察组NLR、PLR、RDW均低于对照组（均 P<0.05）。观察组治疗1、2、3年复发率分别为4.76%（2/42）、14.26%（6/42）、19.05%（8/42），对照组分别为11.90%（5/42）、21.43%（9/42）、26.19%（11/42），两组差异均无统计学意义（均 P>0.05）；观察组治疗1、2、3年总生存率分别为92.86%（39/42）、78.57%（33/42）、71.43%（30/42），对照组分别为85.71%（36/42）、69.05%（29/42）、64.28%（27/42），两组差异均无统计学意义（均 P>0.05）。 结论:XELOX方案与FOLFOX方案治疗结肠癌的近期及远期疗效均相当，均可降低患者血清肿瘤标志物及细胞学指标水平，改善患者预后，其中XELOX方案不良反应少。

abstractsObjective:To compare the effects of XELOX (oxaliplatin + capectabine) regimen and FOLFOX4 (oxaliplatin + calcium leucovorin + fluorouracil) regimen on colon cancer and their influences on serum tumor markers and cytological indexes.Methods:A total of 84 patients with colon cancer treated in Wuhu Hospital of Chinese Medicine of Anhui Province from January 2016 to January 2019 were selected, and the patients were randomly divided into the observation group (XELOX regimen, 42 cases) and the control group (FOLFOX4 regimen, 42 cases) according to the random number table. The efficacy, side effects, the changes of cytological indicators and serum tumor markers before and after chemotherapy between the two groups were compared.Results:The short-term effective rate was 76.19% (32/42) in the observation group and 61.91% (26/42) in the control group, and the difference was not statistically significant (χ 2 = 2.005, P=0.156). The incidence of side effects in the observation group was lower than that in the control group [35.71% (15/42) vs. 59.53% (25/42), χ 2 = 4.773, P = 0.029]. There was no significant difference in the levels of carbohydrate antigen 199 (CA19-9), colon cancer-specific antigen (CCSA-2) and osteopontine (OPN) between the two groups before treatment (all P > 0.05); after treatment, CA19-9, CCSA-2, OPN levels were lower than those before treatment of the two groups (all P < 0.05); after treatment, CA19-9, CCSA-2, OPN levels in the observation group were lower than those in the control group (all P < 0.05). Before treatment, there was no significant difference in the levels of neutrophils to lymphocytes ratio (NLR), platelet-lymphocytes ratio (PLR), and red cell distribution width (RDW) between the two groups (all P > 0.05); the levels of NLR, PLR and RDW after treatment in the two groups were decreased compared with those before treatment (all P < 0.05); NLR, PLR and RDW levels in the observation group after treatment were lower than those in the control group (all P < 0.05). In the observation group, the recurrence rate of 1-year, 2-year, 3-year was 4.76% (2/42), 14.26% (6/42), and 19.05% (8/42), respectively; in the control group, the recurrence rate of 1-year, 2-year, 3-year was 11.90% (5/42), 21.43% (9/42), and 26.19% (11/42), respectively; there was no statistical difference between the two groups (all P > 0.05); in the observation group, the survival rate of 1-year, 2-year, 3-year was 92.86% (39/42), 78.57% (33/42), and 71.43% (30/42), respectively; in the control group, the survival rate of 1-year, 2-year, 3-year was 85.71% (36/42), 69.05% (29/42), and 64.28% (27/42), and there was no statistically significant difference between the two groups (all P > 0.05). Conclusions:XELOX regimen and FOLFOX regimen have similar short-term and long-term effects on patients with colon cancer. They both can decrease the levels of serum tumor markers and cytological indicators of patients, and improve their prognosis, while XELOX regimen has low side effects.