醋酸甲羟孕酮辅助腹腔镜手术治疗子宫内膜癌的临床疗效及对血清CA-125和MMP-9的影响  

Clinical Efficacy and Effect on the Levels of CA-125 and MMP-9 in Patients with Endometrial Carcinoma by Using Medroxyprogesterone Acetate Assisted Laparoscopic Surgery

作　　者：李玲 李惠敏 付明英 LI Ling;LI Huimin;FU Mingying(Beijing Wuzhou Women&Children's Hospital,Beijing,100020)

机构地区：[1]北京五洲妇儿医院

出　　处：《实用癌症杂志》2020年第2期278-281,285,共5页The Practical Journal of Cancer

摘　　要：目的探究醋酸甲羟孕酮辅助腹腔镜手术治疗子宫内膜癌的临床疗效及对血清肿瘤标志物糖类抗原-125(CA-125)和基质金属蛋白酶-9(MMP-9)的影响。方法选取子宫内膜癌患者76例,随机分为对照组和观察组,每组38例。2组患者均进行腹腔镜手术切除癌变组织,术后予以抗感染、镇痛等常规治疗,观察组在此基础上加用醋酸甲羟孕酮。观察并比较2组患者的生活质量核心量表评分(QLQ-C30)及血清肿瘤标志物、转移潜能密切相关分子、炎症因子水平。结果治疗后,2组患者躯体功能评分、角色功能评分、社会功能评分、总健康状况评分均升高,观察组显著高于对照组,差异具有统计学意义(P<0.05)。2组患者CA-125、甲壳质酶蛋白-40(YKL-40)、鳞状细胞癌抗原(SCCAg)、MMP-9、血管内皮生长因子(VEGF)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)水平均降低,观察组显著低于对照组,差异具有统计学意义(P<0.05)。结论子宫内膜癌患者腹腔镜手术后应用醋酸甲羟孕酮进行辅助治疗,能够有效降低MMP-9、CA-125水平,改善炎症环境,抑制肿瘤细胞的生长和转移,有利于患者术后的恢复。Objective To investigate the clinical efficacyand its effect on the levels of serum tumor markers carbohydrate antigen-125(CA-125)and matrix metalloproteinase-9(MMP-9)in patients with endometrial carcinoma by using medroxyprogesterone acetate assisted laparoscopic surgery.Methods 76 patients with endometrial carcinoma were randomly divided into the control group and the observation group,with 38 cases in each group.Both groups of patients underwent laparoscopic surgery to remove cancerous tissue,and received conventional treatment such as anti-infection and analgesia after surgery.The observation group was additionally treated with medroxyprogesterone acetate on this basis.The score of the quality of life scale(QLQ-C30),the levels of serum tumor markers,molecules was closely related to metastatic potential and inflammatory factor were observed and compared between the 2 groups.Results After treatment,the scores of body function,role function,social function and total health status of the 2 groups all increased,and those of the observation group were significantly higher than those of the control group,there had statistical differences(P<0.05).The levels of CA-125,chitinase protein-40(YKL-40),squamous cell carcinoma antigen(SCCAg),MMP-9,vascular endothelial growth factor(VEGF),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-4(IL-4)in the 2 groups all decreased,and those of the observation group were significantly lower than those of the control group,there had statistical differences(P<0.05).Conclusion Adjuvant treatment with medroxyprogesterone acetate after laparoscopic surgery for endometrial carcinoma patients can effectively reduce the levels of MMP-9 and CA-125,improve the inflammatory environment,inhibit the growth and metastasis of tumor cells,and is conducive to the recovery of patients after surgery.

关 键 词：醋酸甲羟孕酮 腹腔镜手术 子宫内膜癌 血清肿瘤标志物 转移潜能相关因子 炎症因子 

分 类 号：R737.33[医药卫生—肿瘤]