支气管动脉化疗栓塞联合放射性粒子植入治疗Ⅲa-Ⅲb期非小细胞肺癌后的肿瘤恶性程度评估

Assessment of tumor malignancy after transbronchial arterial chemoembolization combined with radioactive particle implantation treatment of Ⅲa-Ⅲb stage non-small cell lung cancer

目的:评估支气管动脉化疗栓塞联合放射性粒子植入治疗Ⅲa-Ⅲb期非小细胞肺癌后的肿瘤恶性程度评。方法:60例非小细胞肺癌患者纳入本次研究,按照随机数表法分为观察组及对照组各30例。对照组采取常规GP方案化疗,观察组接受GP化疗+支气管动脉化疗栓塞联合放射性粒子植入治疗,对比两组血清肿瘤标志物、T淋巴细胞亚群水平,侵袭转移相关因子蛋白表达量等差异。结果:观察组治疗后血清CEA、CA125、Cyfra21-1、NSE、SCC-Ag水平均低于对照组(P<0.05);血清CD4^+CD25^+调节性T细胞、CD8^+T细胞水平低于对照组,CD4^+T细胞、NK细胞水平高于对照组(P<0.05);肺泡灌洗液中caspase-3、survivin、bcl-2蛋白表达量低于对照组,p53蛋白表达量高于对照组(P<0.05)。结论:支气管动脉化疗栓塞联合放射性粒子植入治疗可以降低Ⅲa-Ⅲb期非小细胞肺癌肿瘤恶性程度,优化整体病情。

Objective：To evaluate the tumor malignancy after transbronchial arterial chemoembolization combined with radioactive particle implantation treatment of IIIa-IIIb stage non-small cell lung cancer.Methods：A total of 60 patients with non-small cell lung cancer were included in this study and divided into observation group and control group （n =30）according to random number table.Control group received conventional GP chemotherapy,observation group received GP chemotherapy＋ transbronchial arterial chemoembolization combined with radioactive particle implantation treatment,and then differences in the levels of serum tumor markers and T lymphocyte subsets,protein expression levels of invasion and metastasis-related fac-tors,etc.were compared between two groups.Results：Serum CEA,CA125,Cyfra21-1,NSE and SCC-Ag levels of observa-tion group after treatment were lower than those of control group （P 〈0.05）;serum CD4 ＋ CD25 ＋ regulatory T cell and CD8 ＋T cell levels were lower than those of control group while CD4 ＋ T cell and NK cell levels were higher than those of control group （P 〈0.05 ）;caspase-3,surviving and bcl-2 protein expression levels in bronchoalveolar lavage fluid were lower than those of control group while p53 protein expression level was higher than that of control group （P 〈0.05）.Conclusion：Trans-bronchial arterial chemoembolization combined with radioactive particle implantation therapy can reduce the malignant degree of IIIa-IIIb stage non-small cell lung cancer and optimize the overall condition.