胸腔镜下肺叶切除术对NSCLC患者临床效果及TPA、SCC、CYFRA21-1水平的影响

Effects of thoracoscopic lobectomy on clinical outcomes,TPA,SCC and CYFRA21⁃1 levels in patients with NSCLC

目的 探究胸腔镜下肺叶切除术对非小细胞肺癌(NSCLC)患者临床效果及组织多肽抗原(TPA)、鳞癌相关抗原(SCC)、细胞角蛋白19片段(CYFRA21-1)水平的影响。方法 选取2020年1月至2022年6月首都医科大学附属北京世纪坛医院收治的96例NSCLC患者,根据治疗方式不同分为传统组42例(传统开放性肺叶切除术)和胸腔镜组54例(胸腔镜下肺叶切除术)。对比两组手术一般情况、1年后肿瘤控制效果、肺功能相关指标、肿瘤标志物及并发症。结果 胸腔镜组术中出血量少于传统组,胸腔引流时间及住院时间明显短于传统组,差异有统计学意义(P<0.05)。胸腔镜组手术3个月后疾病控制率(DCR)高于传统组,差异有统计学意义(P<0.05)。胸腔镜组括第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)比值、最大通气量(MVV)及最大呼气流量(PEF)均高于传统组,差异有统计学意义(P<0.05)。与术前相比,两组TPA、SCC、CYFRA21-1水平均有所下降,且术后3个月胸腔镜组TPA、SCC、CYFRA21-1水平低于传统组,差异有统计学意义(P<0.05)。胸腔镜组并发症总发生率低于传统组,差异有统计学意义(P<0.05)。结论 胸腔镜下肺叶切除治疗NSCLC患者效果显著,可有效改善患者肺功能,降低TPA、SCC、CYFRA21-1水平,相比传统开放性手术其术后并发症风险低,短期预后更好。

Objective To investigate the effects of thoracoscopic lobectomy on clinical efficacy,tissue polypeptide antigen(TPA),squamous cell carcinoma(SCC)and cytokeratin 19 fragment antigen(CY⁃FRA21⁃1)levels in patients with non⁃small cell lung cancer(NSCLC).Methods 96 patients with NSCLC ad⁃mitted to Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2020 to June 2022 were selected,and according to different treatment methods,they were divided into the traditional group of 42 cases(traditional open lobectomy)and the thoracoscopic group of 54 patients(thoracoscopic lobectomy).The general situation,tumor control effect 1 year later,lung function related indexes,tumor markers and complica⁃tions were compared between the two groups.Results The amount of intraoperative blood loss in the thoracoscopic group was less than that in the traditional group,and the time of thoracic drainage and hospital stay in the thoracoscopic group were significantly shorter than that in the traditional group,and the difference was statistically significant(P<0.05).The Disease control rate(DCR)3 months after thoracoscopic surgery in the thoracoscop⁃ic group was higher than that in the traditional group,and the difference was statistically significant(P<0.05).Forced Expiratory Volume in one second,FEV1,Forced expiratory volume in one second,FEV1,Forced Vital Capacity(FVC)ratio,Maximum Minute Ventilation(MVV)and Maximum expiratory flow(PEF)in the thora⁃coscopic group were all higher than those in the traditional group,with statistical significance(P<0.05).Com⁃pared with pre⁃operation,TPA,SCC and CYFRA21⁃1 levels in the two groups were decreased,and the levels of TPA,SCC and CYFRA21⁃1 in the thoracoscopic group were lower than those in the traditional group 3 months after surgery,and the difference was statistically significant(P<0.05).The total complication rate of thoraco⁃scopic group was lower than that of traditional group,and the difference was statistically significant(P<0.05).Conclusion Thoracoscopic lobectomy has a significant effect on patients with NSCLC,which can effectively improve lung function and reduce the levels of TPA,SCC and CYFRA21⁃1.Compared with traditional open sur⁃gery,it has a lower risk of postoperative complications and a better short⁃term prognosis.