顺铂联合香菇多糖对肺腺癌合并胸腔积液后患者Twist蛋白表皮生长因子受体癌胚抗原水平的影响  

Effects of cisplatin combined with lentinan on levels of Twist protein,EGFR and CEA in lung adenocarcinoma complicated with pleural effusion

作　　者：周顺忠 孙琰玮[2] Zhou Shunzhong;Sun Yanwei(Department of General Surgery,Taiyuan People’s Hospital,Shanxi 030001,China)

机构地区：[1]山西省太原市人民医院外二科,030001 [2]山西医科大学第二医院胸心外科,030001

出　　处：《中国药物与临床》2019年第20期3482-3486,共5页Chinese Remedies & Clinics

摘　　要：目的观察顺铂联合香菇多糖治疗肺腺癌合并胸腔积液的临床疗效,并探讨其与患者血清、胸腔积液Twist蛋白、表皮生长因子受体(EGFR)、癌胚抗原(CEA)水平的关系。方法2016年9月至2018年7月我院诊治的74例肺腺癌合并胸腔积液患者,根据胸腔内化疗方法不同分为治疗组(40例,顺铂联合香菇多糖胸腔内注射治疗)、对照组(34例,顺铂胸腔内注射治疗),3周后复查CT与胸部X线片,评价临床疗效及分析生存情况,评估血清、胸腔积液Twist蛋白、EGFR、CEA水平与化疗效果进行分级及生存指标的关系。结果治疗组临床疗效明显优于对照组,2组临床疗效比较差异有统计学意义(P<0.05)。2组治疗前血清、胸腔积液Twist蛋白、EGFR、CEA水平比较差异无统计学意义(P>0.05),治疗后血清、胸腔积液Twist蛋白、EGFR、CEA水平均明显下降(P<0.05),而治疗组血清、胸腔积液Twist蛋白、EGFR、CEA水平显著低于对照组(P<0.05)。Pearson相关性分析显示,治疗后血清、胸腔积液Twist蛋白、EGFR、CEA水平与化疗效果等级呈正相关(P<0.05)。治疗组中位无进展生存时间(PFS)、中位总生存时间(OS)均较对照组长(P<0.05)。Cox分析显示治疗后血清、胸腔积液Twist蛋白、EGFR、CEA水平与中位PFS、中位OS有关(P<0.05)。2组化疗毒副反应率比较差异无统计学意义(P>0.05)。结论顺铂联合香菇多糖胸腔内注射治疗可有效地提高肺腺癌合并胸腔积液的临床疗效及改善预后,调节血清、胸腔积液Twist蛋白、EGFR、CEA水平,且血清、胸腔积液Twist蛋白、EGFR、CEA水平与临床疗效、预后密切相关,对临床治疗及评估有一定参考价值。Objective To investigate the clinical efficacy of cisplatin combined with lentinan in lung adenocarcinoma complicated with pleural effusion,and to evaluate its relationship with levels of Twist protein,epidermal growth factor receptor(EGFR)and carcinoembryonic antigen(CEA)in the serum and pleural effusion from the patients.Methods Included in this study were 74 patients with lung adenocarcinoma and pleural effusion who were treated in our hospital between September 2016 and July 2018.The subjects were divided into the treatment group(n=40)to receive intrapleural injection of cisplatin plus lentinan,and the control group(n=34)to receive intrapleural injection of cisplatin alone,according to different regimens of intrapleural chemotherapy.Three weeks later,the patients were followed up with CT and chest X-ray to evaluate the clinical efficacy and survival.The relationship between the levels of Twist protein,EGFR and CEA in serum and pleural effusion,the classification outcomes of chemotherapy,and the survival were analyzed.Results The clinical efficacy in the treatment group was significantly better than that in the control group with significant difference between the two groups(P<0.05).There were no significant differences in levels of Twist protein,EGFR or CEA in serum or pleural effusion between the two groups before treatment(P>0.05).The levels of these biomarkers were significantly reduced after treatment in either group(P<0.05),and were significantly lower in the treatment group compared with the control group(P<0.05).Pearson correlation analysis showed that levels of Twist protein,EGFR and CEA in serum and pleural effusion were positively correlated with the classification of chemotherapy outcomes(P<0.05).The median progression-free survival time(PFS)and median total survival time(OS)in the treatment group were longer than those in the control group(P<0.05).Cox analysis showed that serum and pleural effusion levels of Twist protein,EGFR and CEA were correlated with median PFS and OS(P<0.05).There was no sig

关 键 词：顺铂 香菇多糖 肺腺癌 胸腔积液 TWIST蛋白 受体 表皮生长因子 癌胚抗原 

分 类 号：R73[医药卫生—肿瘤]