胸腔热灌注治疗肺癌恶性胸腔积液前后肿瘤标记物的变化研究  

The Change of Levels of Tumor Markers in Lung Cancer Patients With Malignant Pleural Effusion Before and After Intrapleural Hyperthermic Perfusion

作　　者：董彦军[1] 郑先杰[1] 张国瑜[1] 孙明飞[1] 杨忠信[1] 张双林[1] 

机构地区：[1]河南大学第一附属医院胸心血管外科,河南开封475001

出　　处：《中国继续医学教育》2016年第21期89-91,共3页China Continuing Medical Education

摘　　要：目的探讨胸腔热灌注治疗肺癌胸腔积液前后肺癌肿瘤标记物的变化,评估热灌注治疗的疗效。方法 62例肺癌恶性胸腔积液患者,随机分成两组。治疗组经过胸腔热灌注治疗3次,持续1 h,间隔24h。对照组在胸腔闭式引流术后灌注顺铂。检测第1天、第30天血清癌胚抗原(CEA)、神经元特异性烯醇化(NSE)、细胞角质蛋白19片段(CYFRA21-1)、鳞状上皮细胞癌抗原(SCC-AG)水平,结合影像学进行评价。结果治疗组胸液控制总有效率(RR)为96.4%(CR92.1%+PR 4.3%),对照组胸液控制总有效率(RR)为54.2%(CR39.1%+PR 15.1%)。治疗30 d后,治疗组与对照组的CEA、NSE、CY-FRA21-1均明显下降,与治疗前相比,差异有统计学意义(P<0.05)。且治疗组与对照组组间比较,差异有统计学意义(P<0.05)。结论胸腔热灌注治疗肺癌恶性胸腔积液疗效显著,CEA、NSE、CYFRA21-1、SCC-AG可以作为评价肺癌恶性胸腔积液治疗效果的检测指标。Objective To investigate the changes of tumor markers of lung cancer before and after the treatment of lung cancer with pleural effusion. Methods 62 cases of lung cancer with malignant pleural effusion were randomly divided into two groups. The treatment group was treated by pleural perfusion for 3 times, 1 h, 24 h interval. The control group was perfused with cisplatin after closed thoracic drainage. Detection of the ifrst day, the 30th day of serum carcinoembryonic antigen （CEA）, neuron speciifc ene alcoholize （NSE）, cytokeratin protein 19 fragment （CYFRA21-1）, squamous epithelial cell carcinoma antigen （SCC-AG） level, Combined with imaging evaluation. Results The total effective rate （RR） of the treatment group was 96.4%（PR 92.1%＋CR 4.3%）. The total effective rate of the control group （RR） was 54.2%（PR 39.1%＋CR 15.1%）. After 30 d treatment, the treatment group and the control group CEA, NSE, CY-FRA21-1 were significantly decreased, compared with before treatment, the difference was statistically signiifcant （P〈0.05）. And there was signiifcant difference between the treatment group and the control group （P〈0.05）. Conclusion Treatment of malignant pleural effusion of lung cancer with pleural effusion, CEA, NSE, CY-FRA21-1, SCC-AG can be used as the evaluation index to evaluate the therapeutic effect of lung cancer with malignant pleural effusion.

关 键 词：肺癌 热灌注化疗治疗 恶性胸腔积液 肿瘤标记物 

分 类 号：R730[医药卫生—肿瘤]