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| Clinical study of Astragalus granules regulating ferroptosis-related gene expression and immune function in gastric cancer tissue |
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| DOI
10.11656/j.issn.1673-9043.2026.07.04 |
| Key Words
Astragalus granules;gastric cancer;oxaliplatin;leucovorin;5-fluorouracil regimen;sintilimab;ferroptosis;immune function |
| Author Name | Affiliation | E-mail | | REN Yuxiu | Department of Nutrition, Handan Central Hospital, Handan 056000, China | | | LIU Shaopeng | First Department of General Surgery, Handan Central Hospital, Handan 056000, China | 13996810652@163.com | | LIU Dandan | Department of Laboratory Medicine, Handan Seventh Hospital, Handan 056005, China | | | YANG Ruixue | Department of Traditional Chinese Medicine, Handan Central Hospital, Handan 056000, China | | | FENG Zhanjiang | Operating Room, East District, Handan Central Hospital, Handan 056008, China | |
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| Abstract
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| [Objective] To investigate the adjuvant effects of Astragalus granules in patients with advanced gastric cancer（GC）receiving the oxaliplatin + leucovorin + 5-fluorouracil regimen（FOLFOX4）combined with sintilimab （SIN），and to evaluate their impact on immune function and the ferroptosis-related gene prognostic index（FRGPI）. [Methods] A total of 223 patients with advanced GC admitted to our hospital between January 2020 and December 2024 were enrolled and randomly assigned to an observation group（n=111）or a control group（n=112）using a random number table. The control group received the FOLFOX4 regimen plus SIN，while the observation group received additional Astragalus granules on this basis. Each treatment cycle lasted 3 weeks，and all patients completed at least 2 cycles. Short-term efficacy [objective response rate（ORR）]，immune function（percentages of CD3+，CD4+，and CD8+ T cells），FRGPI levels，and adverse reactions were compared between the two groups. [Results] The ORR was significantly higher in the observation group（52.2%）than in the control group（34.9%）（P<0.05）. After treatment，CD3+ and CD4+ levels increased and CD8+ levels decreased in both groups（all P<0.05），with greater changes observed in the observation group（P<0.05）. FRGPI levels were reduced in both groups after treatment（P< 0.05），with a more pronounced decrease in the observation group（P<0.05）. Pearson correlation analysis showed that CD3+ and CD4+ were negatively correlated with FRGPI（P<0.01），while CD8+ was positively correlated with FRGPI（P<0.01）. The incidence of nausea/ vomiting，leukopenia，and hepatic/renal impairment was lower in the observation group than in the control group（P<0.05），whereas the incidence of thrombocytopenia and hand foot syndrome showed no significant differences between the two groups（P>0.05）. [Conclusion] Astragalus granules combined with FOLFOX4 and sintilimab significantly improved short-term efficacy in patients with advanced gastric cancer，enhanced immune function，reduced FRGPI levels，and alleviated certain treatment-related toxicities. These effects may be associated with the regulation of ferroptosis and improvement of the immune microenvironment， providing clinical evidence for the use of Astragalus granules as an adjuvant to immunochemotherapy. |
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