新辅助化疗对直肠癌患者超低位吻合术后近期疗效、血清肿瘤标志物水平及生存质量的影响观察  

Efficacy of neoadjuvant chemotherapy on the short-term outcome,serum tumor markers and quality of life in patients after anastomosis of ultra-low rectal cancer

作　　者：卜延志 贾海峰 张锡山 郑园 李东如 袁从飞 Bu Yanzhi;Jia Haifeng;Zhang Xishan;Zheng Yuan;Li Dongru;Yuan Congfei(Department of General Surgery,Lianshui County People's Hospital,Lianshui Hospital Affiliated to Nanjing Medical University Kangda College,Huaian 223400,Jiangsu,China)

机构地区：[1]涟水县人民医院南京医科大学康达学院附属涟水医院普外科,江苏淮安223400

出　　处：《广州医科大学学报》2021年第5期55-59,共5页Academic Journal of Guangzhou Medical University

基　　金：淮安市自然科学研究计划指导性项目(HABZ202010)。

摘　　要：目的:探究新辅助化疗对直肠癌患者超低位吻合术后近期疗效、血清肿瘤标志物水平及生存质量的影响。方法:选取2016年1月~2018年4月于本院收治的100例直肠癌患者为研究对象,按照随机数表法分为实验组与对照组各50例。对照组患者接受常规手术治疗,实验组患者接受术前新辅助化疗。评估实验组患者术前新辅助化疗结束后疗效,比较两组患者手术疗效差异,探究两组患者治疗前、治疗3个月后血清肿瘤标志物[糖类抗原125(CA125)、糖类抗原199(CA199)、癌胚抗原(CEA)]、生存质量[大肠癌患者生命质量测定量表(FACT-C)]差异,分析两组患者术后并发症发生、2年内复发率差异。结果:实验组患者均完成新辅助化疗,化疗结束后患者CR3例,PR23例,SD20例,PD4例,ORR为52%。实验组患者总体手术疗效高于对照组(P<0.05),两组患者保肛率比较差异不显著(P>0.05)。治疗3个月后,两组患者血清CA125、CA199、CEA均较治疗前降低,且实验组低于对照组(P均<0.05);两组患者FACT-C得分均较治疗前上升,且实验组患者高于对照组(P均<0.05)。两组患者术后并发症发生、复发率差异不显著(P均>0.05)。结论:新辅助化疗对提升直肠癌患者手术疗效有显著作用,能有效降低患者血清肿瘤标志物水平,提升患者生存质量,对患者术后并发症、复发率影响不显著。Objective:To investigate the efficacy of neoadjuvant chemotherapy on the short-term outcome,serum tumor markers,and quality of life in patients after anastomosis of ultra-low rectal cancer.Methods:A total of 100 patients with rectal cancer who were treated in our hospital between January 2016 and April 2018 were included as subjects,and were divided into the study group and the control group according to the random number table(n=50 each).The patients in the control group received conventional surgical treatment,and in addition to this,the patients in the study group were given preoperative neoadjuvant chemotherapy.The treatment efficacy was evaluated in the study group after the end of preoperative neoadjuvant chemotherapy.The two groups were compared for the outcomes of surgery,serum tumor markers[carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),and carcinoembryonic antigen(CEA)],and quality of life[Functional Assessment of Cancer Therapy-Colorectal(FACT-C)]before and at three months after surgery.Postoperative complications and 2-year recurrence were also compared between groups.Results:All patients in the study group completed neoadjuvant chemotherapy.After the end of chemotherapy,there were 3 cases of CR,23 of PR,20 of SD,and 4 of PD,with an ORR of 52%.The overall surgical outcome was more favorable in the study group than that in the control group(P<0.05),with no significant difference in the anus preservation rate between the two groups(P>0.05).At 3 months after treatment,the levels of serum CA125,CA199 and CEA in either group were lower compared with those before treatment,and these levels were even lower in the study than those in the control group(all P<0.05).The FACT-C scores were increased from baseline in either group,and were higher in the study group than those in the control group(all P<0.05).There were no significant differences in postoperative complications and recurrence rate between the two groups(P>0.05).Conclusion:Neoadjuvant chemotherapy leads to significant efficacy in impr

关 键 词：新辅助化疗 直肠癌 超低位吻合术 疗效 血清肿瘤标志物 

分 类 号：R735.37[医药卫生—肿瘤]