术前新辅助化疗在超低位直肠癌内括约肌切除术患者中的应用效果  

Application effect of preoperative neoadjuvant chemotherapy in patients with internal sphinctectomy for ultra-low rectal cancer

作　　者：惠瞳 陈颖慧[1] 王黄震 HUI Tong;CHEN Yinghui;WANG Huangzhen(Department of Anorectal Surgery,Shaanxi Provincial People’s Hospital,Xi’an 710061,Shaanxi,China;Department of Oncology,Baoji Central Hospital,Baoji 721000,Shaanxi,China)

机构地区：[1]陕西省人民医院肛肠外科,西安710061 [2]宝鸡市中心医院肿瘤外科,陕西宝鸡721000

出　　处：《癌症进展》2022年第17期1794-1797,共4页Oncology Progress

摘　　要：目的探讨术前新辅助化疗在超低位直肠癌内括约肌切除术患者中的应用效果。方法依据治疗方法的不同将94例超低位直肠癌患者分为对照组和观察组,每组47例,对照组患者给予内括约肌切除术治疗,观察组患者内括约肌切除术前给予新辅助化疗。比较两组患者的围手术期相关指标、炎性因子[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及白细胞介素-6(IL-6)]水平、肿瘤标志物[糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)]水平、并发症发生情况和随访1年复发、转移情况。结果观察组患者手术时间、术后首次进食时间及术后首次排气时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者TNF-α、CRP、IL-6、CA19-9、CA125、CEA水平均低于对照组,差异均有统计学意义(P<0.05)。观察组患者并发症总发生率、复发率、转移率分别为2.13%、2.13%、0%,分别低于对照组患者的19.15%、19.15%、12.77%,差异均有统计学意义(P<0.05)。结论超低位直肠癌患者内括约肌切除术前应用新辅助化疗,能够提高手术效果,降低炎性因子水平和肿瘤标志物水平。Objective To investigate the effect of preoperative neoadjuvant chemotherapy in patients with internal sphinctectomy for ultra-low rectal cancer.Method According to different treatment methods,94 patients with ultra-low rectal cancer were divided into control group and observation group,47 cases in each group.The patients in the control group were given internal sphincterotomy,and the patients in the observation group were given neoadjuvant chemotherapy before internal sphinctectomy.The perioperative related indexes,inflammatory factor[tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)]levels,tumor marker[carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA)]levels,the incidence of complication,and the recurrence and metastasis during the 1-year follow-up were compared between the two groups.Result The operation time,postoperative first eating time and postoperative first exhausting time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of TNF-α,CRP,IL-6,CA19-9,CA125,and CEA in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence rate of complications,recurrence rate and metastasis rate in the observation group were 2.13%,2.13%,and 0%,respectively,which were lower than 19.15%,19.15%,and 12.77%in the control group,and the differences were statistically significant(P<0.05).Conclusion Neoadjuvant chemotherapy before internal sphinctectomy in patients with ultra-low rectal cancer can improve the surgical effect and reduce the levels of inflammatory factors and tumor markers.

关 键 词：超低位直肠癌 内括约肌切除术 新辅助化疗 

分 类 号：R735.37[医药卫生—肿瘤]