Clinical efficacy of Xiaoaiping combined with mFOLFOX6 regimen administered via the superior rectal artery and its impact on the PI3K/AKT signaling pathway in patients with rectal cancer complicated with obstruction

LIU Haitao; ZHAO Yuelian; CUI Shuang; MIAO Lingling; MA Pan

doi:10.3969/j.issn.1002-3429.2025.19.007

Abstract：Objective To investigate the clinical efficacy of Xiaoaiping combined with the mFOLFOX6 regimen administered via the superior rectal artery in patients with rectal cancer complicated by obstruction,and its impact on the phosphatidylinositol 3-kinase(PI3K)/serine-threonine protein kinase(AKT)signaling pathway..Methods A total of 124 patients with rectal cancer complicated with obstruction who required emergency surgery from January 2021 to February 2024 were selected and divided into the control group and the research group by random number table method,with 62 patients in each group.The control group was given the mFOLFOX6 regimen,while the research group was given Xiaoaiping via the superior rectal artery on this basis.The curative effects,tumor markers[carcinoembryonic antigen(CEA),cancer antigen(CA)72-4,CA19-9,CA125],disease-related indicators[tumor necrosis factor-α(TNF-α),transforming growth factor β1(TGF-β1),matrix metalloproteinase-7(MMP-7),Smad-7],and PI3K/AKT signaling pathway,immune-related indicators[CD4+,CD4+/CD8+,IgM,IgA],quality of life[European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire(EORTC QLQ-C30)Chinese version],adverse reactions and complications were compared between the two groups.Results The total effective rate of the research group was 80.65%(50/62),which was higher than that of the control group at 61.29%(38/62)(P<0.05)),while there was no significant difference in the disease control rate between the two groups(P>0.05).After treatment,the mRNA expression levels of CA72-4,CA19-9,CEA,CA125,TGF-β1,MMP-7,TNF-α,PI3K and AKT in the research group were lower than those in the control group,while the levels of Smad-7,CD4+,IgM,CD4+/CD8+and IgA were higher than those in the control group(P<0.05).After treatment,the scores of physical,emotional and social functions and the total score of EORTC QLQ-C30 in the research group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions,complications and the grading of adverse reaction severity between the two groups(P>0.05).Conclusions The combined administration of Xiaoaiping via the superior rectal artery in patients undergoing emergency surgery for rectal cancer with obstruction has a remarkable anti-cancer effect.It can enhance the body's immunity,inhibit tumor angiogenesis,regulate the PI3K/AKT signaling pathway,improve the quality of life of patients,and has high safety.