新辅助化疗联合肿瘤细胞减灭术治疗晚期上皮性卵巢癌的随访观察  

Follow-up Observation of Neoadjuvant Chemotherapy Combined with Tumor Cell Reduction in the Treatment of Advanced Epithelial Ovarian Cancer

作　　者：谭细凤[1] 李怀芳[2] 谷雨枫 

机构地区：[1]武警浙江省总队嘉兴医院,浙江嘉兴314000 [2]同济大学附属同济医院,上海200065

出　　处：《实用妇产科杂志》2017年第1期62-65,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:新辅助化疗(NACT)联合肿瘤细胞减灭术治疗晚期上皮性卵巢癌的随访观察。方法:将纳入研究的128例晚期上皮性卵巢癌依据术前评估能否进行理想细胞减灭术分为观察组(67例)和对照组(61例),观察组无法进行理想细胞减灭术,故先给予NACT,之后行肿瘤细胞减灭及常规化疗;对照组可进行理想细胞减灭术,给予肿瘤细胞减灭术及常规化疗。6~8个化疗周期后观察两组患者疗效以及人附睾分泌蛋白4(HE4)、糖类多肽抗原125(CA_(125))变化,随访3年统计生存率及复查HE4、CA_(125)。结果:观察组总有效率71.64%,对照组总有效率41.79%,两组总有效率比较差异有统计学意义(χ~2=8.7704,P<0.05)。治疗后,两组HE4、CA_(125)均较本组治疗前明显下降(P<0.05),且观察组下降幅度更大,两组治疗后各指标比较差异均有统计学意义(P<0.05)。随访1年,观察组生存率89.55%(60/67),对照组生存率80.33%(49/61),两组比较差异无统计学意义(χ~2=2.1494,P>0.05),但两组HE4、CA_(125)水平差异有统计学意义(P<0.05)。随访3年,观察组生存率73.13%(49/67),对照组生存率50.75%(34/61),差异有统计学意义(χ~2=4.2389,P<0.05),两组HE4、CA_(125)水平差异也有统计学意义(P<0.05)。结论:NACT联合肿瘤细胞减灭术可提高晚期上皮性卵巢癌的临床疗效,有助于改善患者预后。Objective： Follow-up survey to neoadjuvant chemotherapy（ NACT） combined with tumor cell reduction in the treatment of advanced epithelial ovarian cancer.Methods： 128 patients with advanced epithelial ovarian cancer were divided into observation group（ 67 cases） and control group（ 61 cases） according to preoperative evaluation.The observation group was unable to carry out the ideal cell reduction surgeryso treated with NACT first and then tumor cell reduction and conventional chemotherapy. The control group was able to perform ideal cell subtraction so given tumor cell reduction and conventional chemotherapy. After 6- 8 chemotherapy cycles,observed the efficacy and changes of HE4 and CA（125）; Followed up 3 years and analyzed the survival rate,the efficacy and changes of HE4 and CA（125）.Results： The total effective rate of the observation group was 71. 64%,and the control group was 41. 79%,the difference was statistically significant（ χ2= 8. 7704,P〈0. 05）; After the treatment,two groups of HE4 and CA（125） were decreased significantly（ P〈0. 05） compared with those before treatment,but the observation group decreased more,all index of the two groups had statistical significance（ P〈0. 05）; Followed up 1 year,the survival rate of observation group was 89. 55%（ 60 /67）,the control group was 80. 33%（ 49 /61）,the difference was no statistically significant（ χ2 4. 2389,P〈0. 05）,but there were statistical differences in the levels of HE4 and CA（125） between the two groups at this time（ P〈0. 05）.Followed up 3 years,survival rate of the observation group was 73. 13%（ 49 /67）,the control group was 50. 75%（ 34 /61）,the difference was statistically significant（ χ2 4. 2389,P〈0. 05）,and there were statistical differences in the levels of HE4 and CA（125） between the two groups at this time（ P〈0. 05）.Conclusions： NACT combined with tumor cell reduction can improve the clinical efficacy of advanced epithelial ovarian cancer,and can he

关 键 词：新辅助化疗 肿瘤细胞减灭术 晚期卵巢癌 疗效 人附睾分泌蛋白4 糖类多肽抗原125 

分 类 号：R737.31[医药卫生—肿瘤]