胸腔镜下肿瘤切除并热灌注对肺癌恶性胸水的疗效分析

Therapeutic effect on patients with lung cancer and malignant pleural effusion by Transthoracoscopic resection with hyperthermic perfusion

目的从肺癌相关的肿瘤标志物角度分析胸腔镜下胸膜肿瘤切除并胸膜热灌注术对肺癌伴恶性胸水患者的治疗效果。方法肺癌伴随恶性胸水患者41例为研究组,进行胸腔镜下胸膜活检及肿瘤切除并热灌注;将同期进行单独胸腔化疗的患者34例作为对照组。观察两组治疗前后血清和胸水肺癌标记物含量变化,并比较患者生存率。结果与对照组比较,治疗后研究组胸水CEA、Cyfra21-1、CA-125及血Cyfra21-1、CA-125明显下降(P<0.05)。与治疗前比较,治疗后研究组胸水及血液CA-125、Cyfra21-1、CEA降低(P<0.05);研究组患者1年生存率75.6%,2年生存率43.9%,明显优于对照组(P<0.05)。结论从肺癌相关的肿瘤标志物角度提示胸腔镜下胸膜肿瘤切除并热灌注术对于肺癌伴恶性胸水患者治疗效果好。

Objective To analysis the effect of transthoracoscopic resection with hyperthermic perfusion on lung cancer patients with malignant pleural effusion by detection of tumor markers related lung cancer ,Methods Re-search group included 41 patients with lung cancer with malignant hydrothorax ,using transthoracoscopic resection and hyperthermic perfusion .Control group included 34 cases ,who using the chest cavity chemotherapy alone in the corresponding time period .Observe the variance of lung cancer markers in serum and pleural effusion of two groups before and after treatment ,and compare the survival rate of two groups .Results Compared with the control group ,the CEA ,Cyfra21 -1 ,CA -125 in pleural fluid and Cyfra21 -1 ,CA -125 in blood serum of reserch group decreased （ P 〈0 .05） ,and the serum CA-125 ,Cyfra21-1 ,CEA of research group decreased signifi-cantly after the treatment （ P 〈0 .05 ） .The one year survival rate of patients in research group was 75 .6% ,two years survival rate 43 .9% ,significantly higher than the control group （ P 〈0 .05） .Conclusion The effect of treatment on lung cancer patients with malignant pleural effusion by transthoracoscopic resection with hyperthermic perfusion is good viewed from the related tumor markers of lung cancer .