新辅助化疗治疗晚期子宫内膜癌患者的疗效及对患者血清CA19-9、HE4、TGF-β1水平的影响  

Neoadjuvant Chemotherapy for Advanced Endometrial Cancer and its Effects on Serum CA19-9,HE4 and TGF-β1

作　　者：王榆平 康红梅 WANG Yu-ping;KANG Hong-mei(Department of Gynecology,Second Hospital of Yulin,Yulin Shaanxi 719000)

机构地区：[1]榆林市第二医院妇科,陕西榆林719000 [2]榆林市榆区妇幼保健院妇产科,陕西榆林719000

出　　处：《医学临床研究》2023年第3期337-339,343,共4页Journal of Clinical Research

基　　金：陕西省榆林市科技计划项目(编号:YF-2021-63)。

摘　　要：【目的】探讨新辅助化疗(NACT)治疗晚期子宫内膜癌(EC)患者的疗效及对患者血清糖类抗原199(CA19-9)、人附睾蛋白4(HE4)、转化生长因子-β1(TGF-β1)水平的影响。【方法】选择2015年1月至2019年12月在榆林市第二医院诊治的112例晚期EC患者,按照随机数字表法分为观察组和对照组,每组56例,两组均在腹腔镜下行子宫内膜癌根治术,观察组术前行NACT治疗,术后行常规化疗,对照组术后行常规化疗。比较两组手术相关指标、Ⅲ~Ⅳ级毒副反应发生率、3年生存率及治疗前后血清CA19-9、HE4、TGF-β1等肿瘤标志物水平。【结果】观察组患者术中出血量、手术时间、住院时间均少于对照组患者,差异具有统计学意义(P<0.05);治疗后,观察组血清CA19-9、HE4、TGF-β1水平均低于对照组(P<0.05);两组患者Ⅲ~Ⅳ级毒副反应发生率和3年生存率比较,差异无统计学意义(P>0.05)。【结论】NACT治疗晚期EC患者,可将不可手术病灶降期为可手术病灶,术后恢复快,还可抑制CA19-9、HE4、TGF-β1生成,且并不会显著增加毒副反应,值得临床推广应用。【Objective】To study the effects of neoadjuvant chemotherapy(NACT)on serum carbohydrate antigen 199(CA19-9),human epididymal protein 4(HE4)and transforming growth factor-β1(TGF-β1)in the treatment of advanced endometrial carcinoma(EC).【Methods】A total of 112 patients with advanced EC treated in Second Hospital of Yulin from January 2015 to December 2019 were selected and divided into the observation group and the control group according to random number table method,with 56 patients in each group.The two groups underwent laparoscopic radical gastrectomy for endometrial cancer.The observation group received NACT before surgery and routine chemotherapy after surgery,while the control group only received routine chemotherapy after surgery.Operation related indicators,serum CA19-9,HE4,TGF-β1 and other tumor markers before and after treatment,the toxicity(Ⅲ-Ⅳ)and 3-year survival of the two groups were observed and compared.【Results】The intraoperative blood loss,operation time and hospitalization time of the observation group were all less than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of serum CA19-9,HE4 and TGF-β1 in the observation group were lower than those in control group(P<0.05).There was no difference in toxicities ofⅢtoⅣbetween the two groups(P>0.05).There was no difference in 3-year survival rate between the two groups(P>0.05).【Conclusion】NACT treatment for advanced EC can reduce the non-operable lesions to operable ones,and can inhibit levels of CA19-9,HE4,and TGF-β1 with no significant increase in toxicity.

关 键 词：子宫内膜肿瘤 化学疗法 辅助 CA19-9抗原/血液 附睾分泌蛋白质类/血液 转化生长因子β1/血液 

分 类 号：R737.33[医药卫生—肿瘤]