小细胞肺癌患者基于肿瘤标志物异常更换化疗方案对疗效的影响  

Effect of abnormal replacement of chemotherapy regimen based on tumor markers of patients with small cell lung cancer

作　　者：李鑫 孙韬 LI Xin;SUN Tao(Department of Oncology, Beijing Hospital Traditional Chinese Medicine, Beijing 101300, China)

机构地区：[1]北京中医医院顺义医院肿瘤科,北京101300

出　　处：《中国肿瘤外科杂志》2020年第3期198-202,共5页Chinese Journal of Surgical Oncology

基　　金：北京中医药科技项目(JJ2016-57)。

摘　　要：目的探讨小细胞肺癌治疗过程中出现肿瘤标志物升高后的治疗策略。方法通过北京中医医院顺义医院病历资料管理系统筛选2014年2月至2019年2月之间经治的小细胞肺癌患者156例,根据肿瘤标志物升高情况及是否更换化疗方案进行分组,分为CEA组(未更换20例,更换19例)、NSE组(未更换21例,更换22例)、CYFRA21-1组(未更换18例,更换22例)和NSE+CYFRA21-1组(未更换16例,更换18例)。以各组改变治疗方案后肿瘤标志物变化情况及各组间从开始治疗到疾病进展的时间(TTP)为疗效观察指标。结果CEA组、CYFRA21-1组更换与未更换化疗方案者相比肿瘤标志物变化差异无统计学意义(P>0.05);NSE组、NSE+CYFRA21-1组更换与未更换化疗方案者相比肿瘤标志物变化差异有统计学意义(P<0.05)。CEA组、NSE组、CYFRA21-1组更换与未更换化疗方案患者的中位TTP差异无统计学意义(P>0.05);NSE+CYFRA21-1组更换与未更换化疗方案患者的中位TTP差异有统计学意义(P<0.01)。结论建议小细胞肺癌化疗患者当两项肿瘤标志物水平均异常升高时更换化疗方案,不推荐单一肿瘤标志物异常升高更换化疗方案。Objective To explore the treatment strategy of small cell lung cancer(SCLC)with elevated tumor markers.Methods A total of 156 patients with SCLC treated between February 2014 and February 2019 were screened through the medical records management system of Shunyi Hospital of Beijing Traditional Chinese Medicine Hospital.The patients were divided into four groups according to the elevated tumor markers and whether to change the chemotherapy regimen.In the CEA group:20 patients did not change and 19 patients changed.In the NSE group,21 patients did not change and 22 patients changed.In the CYFRA21-1 group:18 patients did not change and 22 patients changed.In the NSE+CYFRA21-1 group:16 patients did not change and 18 patients changed.The changes of tumor markers after the change of treatment regimen in each group and the time from the start of treatment to the progression of disease(TTP)were used as the efficacy observation indexes.Results In CEA and CYFRA21-1 group,there was no significant difference in tumor markers between patients who changed chemotherapy regimen and those who did not(P>0.05).There was a statistically significant difference in NSE group and NSE+CYFRA21-1 group.The median TTP of changed chemotherapy regimen and no changed showed no difference in In CEA group,NSE group,and CYFRA21-1 group(P>0.05).While the median TTP of changed chemotherapy regimen and no changed in NSE+CYFRA21-1 group showed a significantly difference.Conclusions It is recommended to change the chemotherapy regimen when the levels of both tumor markers are abnormally elevated,and it is not recommended to change the chemotherapy regimen when a single tumor marker is abnormally elevated.

关 键 词：肿瘤标志物 化疗 小细胞肺癌 疗效 

分 类 号：R73[医药卫生—肿瘤]