培美曲塞治疗晚期肺腺癌时监测Hcy的意义  

Changes of Serum Hcy Levels in Advanced Lung Adenocarcinoma during Pemetrexed Chemotherapy

作　　者：胡冬[1] 吴茜[1] 陈刚[1] 庄利东[1] 陈曦[1] 朱华强[1] 张薇[1] 赵振华[1] 

机构地区：[1]绵阳市中心医院,四川绵阳621000

出　　处：《现代临床医学》2016年第6期437-440,共4页Journal of Modern Clinical Medicine

摘　　要：目的:研究肺腺癌患者采用培美曲塞化疗过程中血清Hcy水平的变化,探索血清Hcy水平变化在肺腺癌患者采用培美曲塞化疗疗效预测中的作用。方法:回顾性分析我院肺腺癌采用培美曲塞化疗患者57例,根据治疗过程中的影像学检查结果,评价治疗效果,分别于化疗前和化疗第2周期结束后,清晨空腹抽取静脉血检测Hcy水平,对患者临床特征、化疗前后Hcy水平及其变化与临床疗效的关系进行统计学分析。结果:研究对象采用培美曲塞化疗效果为:CR 0例、PR 19例、SD 22例、PD 16例,ORR为33.3%,DCR为71.9%,各临床因素与培美曲塞治疗疗效ORR、DCR均无相关性;治疗前血清Hcy水平的高低对化疗的疗效无明显影响,治疗后血清Hcy水平正常者DCR明显高于血清Hcy水平异常者(P<0.05),化疗前后PR组和SD组Hcy水平变化有显著性差异(P<0.05),化疗后Hcy水平降低患者ORR及DCR均明显高于血清Hcy水平升高患者(P<0.05)。结论:肺腺癌患者采用培美曲塞化疗过程中监测血清Hcy水平的变化,可以预测肺腺癌患者化疗疗效。Objective：To study the changes of serum Hcy levels in patients with advanced lung adenocarcinoma during pemetrexed （ PEM） chemotherapy , and to investigate the value of these changes in predicting chemotherapeutic efficacy of PEM in patients with advanced lung adenocarcinoma .Methods： 57 cases of lung adenocarcinoma were retrospectively analyzed .The therapeutic efficacy was evaluated according to imaging examination .Fasting venous blood in luce prima was extracted for the determination of Hcy levels before chemotherapy and after two chemotherapeutic cycles .The clinical features and Hcy levels before and after chemotherapy were statistically analyzed .Results： Of 57 cases, there were 0 case of CR,19 cases of PR,22 cases of SD and 16 cases of PD ;the ORR was 33.3% and DCR was 71.9%.No significant correlations were found between clinical factors and ORR or DCR .Before chemotherapy , serum Hcy levels showed no significant influence on efficacy;however , patients with normal Hcy levels had significantly higher DCR than those with abnormal Hcy levels （P〈0.05）;the changes of Hcy levels showed significant difference between PR group and SD group （ P 〈0.05 ）; patients with decreased Hcy levels after chemotherapy had higher ORR and DCR than those with increased Hcy level （ P〈0.05 ） .Conclusion： The chemotherapeutic efficacy of PEM in the treatment of advanced lung adenocarcinoma can be predicted by detecting the changes of Hcy levels during the chemotherapy.

关 键 词：肺腺癌 培美曲塞 HCY 疗效 预测 

分 类 号：R734.2[医药卫生—肿瘤]