进展期食管胃交界部腺癌患者术后腹腔热灌注化疗对血清肿瘤标志物的影响

The influence of postoperative hyperthermic intraperitoneal perfusion chemotherapy on serum tumormarkers in advanced adenocarcinoma of esophagogastric junction

目的探讨食管胃交界部腺癌患者术后超早期给予紫杉醇腹腔热灌注化疗对血清肿瘤标志物的影响。方法纳入2014年7月至2015年12月安阳市肿瘤医院行根治性手术治疗的进展期食管胃交界部腺癌共172例，其中87例给予术后超早期紫杉醇腹腔热灌注化疗，并给予常规处理，85例仅给予常规处理。结果术后9d（即腹腔热灌注化疗后7d），腹腔热灌注治疗组中血清CEA为（2．8±1．3）rig／ml、CAl9-9为（22±8）IU／ml和CA72—4为（4．1±1．9）IU／ml，阳性率分别为5％、7％和11％；常规组中血清CEA为（3．4±1．2）ng／ml、CA19-9为（25±11）IU／ml和CA72—4为（4．8±2．I）IU／ml，阳性率分别为14％、13％和19％，两组相比差异均有统计学意义（t=2．453，P=0．015：t=2．241，P=0．026；t=2．154．P=0．033）。结论术后给予进展期食管胃交界部腺癌患者超早期紫杉醇腹腔热灌注化疔可使血清肿瘤标志物下降．使体内癌负荷进一步降低。

Objective To evaluate the changes of CEA, CA19-9, CA72- 4 of patients with advanced adenocarcinoma of the esophagogastric junction （AEGJ） who received ultra-early precise hyperthermic intraperitoneal perfusion chemotherapy （HIPEC） with paclitaxel （PTX） after radical surgery. Methods From Jul 2014 to Dec 2015 postoperative advanced AEGJ patients were divided to receive uhra- early precise HIPEC （87 cases, HIPEC group） and conventional therapy group （85 cases） in early stage after radical surgery. Serum levels of CEA, CA19-9 and CA72-4 were examined on preoperative day 1 and postoperative day 9. Results On post-op day 9, the level of CEA, CA19-9 and CA72-4 was （2. 8 ± 1.3） ng/ml, （22 ± 8） IU/ml, （4. 1 ± 1.9） IU/ml in HIPEC group, while that was （3.4 ± 1.2） ng/ml, （25 ± 11 ） IU/ml, （4. 8 ± 2. 1 ） IU/ml in control group respeetively（ t = 2. 453, P -- 0. 015 ; t = 2. 241, P = 0. 026 ; t = 2. 154, P = 0. 033 ）. Conclusion Ultra-early PTX-based HIPEC with advanced AEGJ after radieal surgery lowers serum tumor makers of CEA, CA19-9, CA72-4, reducing body＇s tumor burden.