培美曲塞联合顺铂化疗对晚期非小细胞肺癌患者疗效及血清肿瘤标志物的影响

The Efficacy of Pemetrexed Combined Cis-platinum Chemotherapy for Patients with Advanced Non Small Cell Lung Cancer and the Effect on Serum Tumor Markers

目的:探究培美曲塞联合顺铂化疗对晚期非小细胞肺癌患者疗效及血清肿瘤标志物的影响。方法:选取于2012年7月~2016年2月期间我院收治的89例非小细胞肺癌患者为研究对象,采用随机数字法将研究对象分为观察组(45例)和对照组(44例);观察组采用培美曲塞联合顺铂化疗,对照组采用多西他赛联合顺铂化疗,观察并比较两组患者治疗前后细胞角质素片段抗原(CYRAF211)、血清癌胚抗原(CEA)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)表达水平。结果:观察组疗效优于对照组,比较有统计学差异(Z=1.940,P=0.026),观察组治疗的总有效率(55.66%)显著高于对照组(36.37%),差异有统计学意义(χ2=5.432,P=0.034);化疗后,两组CEA、CYFRA21-1、CA125及NSE水平均较化疗前较有显著下降,同时观察组各指标水平均显著低于对照组(P<0.05);化疗前,Ⅲ期患者肿瘤标志物CEA、CYFRA21-1、CA125及NSE水平均显著低于Ⅳ期患者(P<0.05);化疗后,Ⅲ期和Ⅳ期患者肿瘤标志物CEA、CYFRA21-1、CA125及NSE水平较治疗前均有显著降低(P<0.05),且Ⅲ期水平显著低于Ⅳ期(P<0.05)。结论:培美曲塞联合顺铂治疗晚期非小细胞肺癌具有显著疗效,血清CEA、CYFRA21-1、CA125及NSE水平经化疗后显著降低,可作为分期和评价化疗疗效的可靠指标。

Objective： To explore the efficacy of pemetrexed combined cis-platinum in the chemotherapy of patients with advanced non small cell lung cancer and the effect of serum tumor markers. Methods： 89 cases were selected from January 2014 to 2016 in our hospital for treatment of non small cell lung cancer. All cases were divided into observation group （45 cases） and control group （44 cases）; 45 cases of were treated with pemetrexed combined cis-platinum and 44 cases in the control group with docetaxel combined cis-platinum. The cell keratin fragment antigen （CYFRA21-1）, serum cancer embryo antigen （CEA）, carbohydrate antigen 125 （CA125） and neuron specific （NSE） expression level were observed and compared between the two groups before and after treatment, Results： Statistically significant differences have been found in curative effects between the treatment group and control group （Z=1.940, P=0. 026）. The total effective rate in observation treatment group （55.66%） was significantly higher than that of the control group （36.37%） with significant differences （X2=5.432, P=0.034）, After chemotherapy, the two groups of CEA, CYFRA21-1, CA125 and NSE levels were was significantly decreased compared before chemotherapy and CEA, CYFRA21-1, CA125 and NSE levels in observation treatment group were significantly lower than those in the control group（P〈0.05）; Before chemotherapy, the levels of CEA, CYFRA21-1, CA125 and NSE in III phase were significantly lower than those of the IVphase （P〈0.05） and in both III phase and IVphase, CEA, CYFRA21-1, CA 125 and NSE levels decreased significantly after chemotherapy, and those level of stage III was significantly lower than that of IVphase after chemotherapy （P〈0.05）. Conclusion： The clinical efficacy ofpemetrexed combined with cisplatinum chemotherapy in patients with advanced non small cell lung cancer was significant and the levels of serum CYFRA21-1, CEA, CA125 and NSE decreased after chemotherapy. These makers can be used as indicators of evaluation of chemotherapy efficacy and clinical staging.