食管癌患者新辅助化疗前后生理指标变化及意义  

Changes and Significance of Physiological Indexes in Esophageal Cancer Patients Before and After Neoadjuvant Chemotherapy

作　　者：王文重 伊扬 董晓昕 贾英会 张俊霞 宋晓萌 WANG Wen-zhong;YI Yang;DONG Xiao-xin;JIA Ying-hui;ZHANG Jun-xia;SONG Xiao-meng(Department of Oncology,Cancer Hospital of Huanxing,Chaoyang District,Beijing 100123,China)

机构地区：[1]北京市朝阳区桓兴肿瘤医院肿瘤内科,北京100123

出　　处：《医学信息》2022年第9期116-119,共4页Journal of Medical Information

摘　　要：目的探讨食管癌新辅助化疗前后的生理指标变化及临床意义。方法收集我院2017年1月-2020年2月经过新辅助化疗(NAC)后手术切除的局部晚期食管癌及食管胃交接性腺癌或鳞癌患者104例资料,比较血清营养学指标、血清炎性指标、血清免疫学指标、肿瘤标志物等指标在接受NAC前后的差异。结果28例患者肿瘤中度/完全消退(26.92%)、25例患者肿瘤轻度消退(24.04%)、51例患者肿瘤未见明显消退(49.04%);食管癌患者新辅助化疗后血清营养学指标(血红蛋白、白蛋白、总蛋白)、血清炎性指标(白细胞、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值)均低于化疗前,差异有统计学意义(P<0.05);在食管癌患者NAC不同疗效组血清营养学指标、炎性指标均低于化疗前,差异有统计学意义(P<0.05);不同治疗方案的食管癌患者IgG、IgA、CEA、CA242均低于治疗前,差异有统计学意义(P<0.05)。结论食管癌患者在接受NAC后血清营养指标、炎性指标等指标明显降低,应关注中晚期食管癌患者在接受NAC治疗后营养水平和炎性指标变化,为患者接受下一步治疗提供临床证据。Objective To investigate the changes and clinical significance of physiological indexes before and after neoadjuvant chemotherapy for esophageal cancer.Methods The data of 104 patients with locally advanced esophageal cancer and esophagogastric junction adenocarcinoma or squamous cell carcinoma who underwent surgical resection after neoadjuvant chemotherapy(NAC)in our hospital from January 2017 to February 2020 were collected.The differences of serum nutritional indexes,serum inflammatory indexes,serum immunological indexes and tumor markers before and after NAC were compared.Results A total of 28 patients had moderate/complete regression(26.92%),25 patients had mild regression(24.04%),and 51 patients had no significant regression(49.04%).The serum nutritional indexes(hemoglobin,albumin,total protein)and serum inflammatory indexes(leukocyte,neutrophil/lymphocyte ratio and platelet/lymphocyte ratio)in patients with esophageal cancer after neoadjuvant chemotherapy were lower than those before chemotherapy,the difference was statistically significant(P<0.05).The serum nutritional and inflammatory indexes of patients with esophageal cancer in NAC groups with different therapeutic effects were lower than those before chemotherapy,and the difference was statistically significant(P<0.05).IgG,IgA,CEA and CA242 of esophageal cancer patients with different treatment regimens were lower than those before treatment,and the difference was statistically significant(P<0.05).Conclusion The serum nutritional index and inflammatory index of patients with esophageal cancer after receiving NAC are significantly reduced.Attention should be paid to the changes in nutritional level and inflammatory index of patients with advanced esophageal cancer after receiving NAC treatment,so as to provide clinical evidence for patients to receive the next treatment.

关 键 词：食管恶性肿瘤 新辅助化疗 肿瘤消退 生理指标 

分 类 号：R735.1[医药卫生—肿瘤]