肺癌恶性胸水患者重组人血管内皮抑素联合顺铂方案胸腔化疗后胸水肿瘤标志物变化与疗效.docVIP

肺癌恶性胸水患者重组人血管内皮抑素联合顺铀方案胸腔化疗后胸水肿瘤标志物变化与疗效的相关性 韩云迪吉(通讯 )杨生虎 (青海大学附属医院青海西宁810001) 】A的观察肺癌恶性胸水患者在重组人血管内皮抑素联合顺铂方案 胸腔化疗后胸水肿瘤标志物的变化。方法分析接受管内皮抑素联合顺铂胸腔化 疗的肺癌患者36例，观察治疗前后肿瘤标志物CEA、TPS及CYFRA21-1的变化， 并根据治疗前后影像学结果的改变来进行对比。结果治疗后CEA、TPS及 CYFRA21-1均值与化疗前都有不同程度下降，其屮CEA K降44.3%(P0.05)，TPS 下降53.32% (P0.05),CYFRA21-l下降32.15% (P0.05)。患者肿瘤标志物疗效与 临床疗效的相关性分析结果表明,CEA、TPS、CYFRA21-1的疗效与临床疗效呈正 相关。三者联合检测与临床疗效呈正相关。结论肺癌恶性胸水患者肿瘤标志物 CEA、CA125、CYFRA21-1水平的改变是反映血管内皮抑素疗效的可靠指标，通过 监测患者胸水肿瘤标志物水平的改变可以协助判断治疗疗后疗效。 关键词】恶性胸水血管内皮抑素/顺铂肿瘤标志物 屮图分类号】R563 】A 】2095-1752 (2014) 06-0096-02 Abstract】 Objective Observe lung cancer patients with malignant pleural effusion in rh-endostation cisplatin chemotherapy scheme after malignant pleural effusion tumor markers of change. Methods Analysis accept rh-endostation cisplatin chemotherapy patients with lung cancer of the malignant pleural effusion 36 cases, observed before and after treatment of tumor marker CEA, TPS and CYFRA21-1 changes, and according to the results of the imaging before and after treatment to change to are compared. Results After chemotherapy, tumor markers like CEA, TPS and CYFRA21-lwere decreased, in which CEA, TPS and CYFRA21-1 diminished 44.3% (P0.05), 53.32% (P0.05), and32.15% (P0.05).CEA, TPS, CYFRA 21-1 the curative effect and the clinical curative effect were positively correlated. The three joint test was positively associated with the clinical effect. Conclusion Chest water CEA, CA125 and CYFRA21-1 represent reliable markers for chemotherapy efficacy on patients with lung cancer. Monitoring changes of serum levels of tumor markers would benefit for assessment of chemotherapy efficacy Key words】Malignant pleural effusion rh-endostation/ cisplatin tumor markers 恶性胸水是晚期肺癌的常见并发症，此类患者不宜手术亦无放疗指征。从诊 断到死亡平均约3个月［1］。B前临床多采用胸腔灌注化疗、手术、免疫及热疗 的综合治疗模式，但总体疗效冇限。分子靶向药物血管内皮抑素(恩度)抑制肿 瘤新生血管形成，毒性低且不易产生耐药。己广泛应用于恶性胸水的治疗中［2】［3】。 0前分子靶向药物治疗恶性胸水的疗效参照WHO实体瘤标准，通过影像学的方 式来观察治疗是否有效。由于血管内皮抑素与细胞毒性药物作用机制不同，单纯 以体积判定治疗是否有效，可能低估了疗效和生存质量。［4】［5】如何判定疗效，对 于患者进一步治疗及预后至关重要。肿瘤标