肺癌患者保守治疗前后CT影像学改变及疗效评估分析

Analysis of CT Imaging Changes and Curative Effect Evaluation of Lung Cancer Patients before and after Conservative Treatment

目的评价中晚期肺癌保守治疗前后的CT影像学改变及疗效。方法对40例中晚期肺癌病例(其中Ⅲb期24例、Ⅳ期16例),采取TP方案化疗联合参芪扶正注射液治疗,21天为1个周期,分别于治疗前与治疗2个周期后检测血清癌胚抗原(CEA)与癌抗原125(CA125),进行疗效评价,并比较治疗前后的CT影像学改变。结果治疗前、后肿瘤平均直径分别为(4.16±0.72)cm和(3.26±0.25)cm,差异有统计学意义(t=7.823,P<0.05)。治疗2个周期后,CT检查显示患者肺内原发病灶减少,肺门淋巴结明显缩小,肺内转移灶基本消失。治疗后血清CEA、CA125水平均下降,Ⅲb期病例组CEA为(38.03±8.83)μg/L,低于Ⅳ期病例组(46.33±9.25)μg/L(P<0.05);Ⅲb期病例组CA125为(31.08±8.77)U/ml,低于Ⅳ期病例组(37.66±9.41)U/ml(P<0.05)。Ⅲb期病例组的缓解率(66.67%)高于Ⅳ期病例组(31.25%)(P<0.05)。Ⅲb期组的MPFS为13.64个月,Ⅳ期组的MPFS为9.27个月,两组生存情况的差异有统计学意义(Log-rankχ2=16.74,P<0.05)。结论中晚期肺癌患者采取保守治疗能取得较满意的近期疗效,提高患者的缓解率。

Objective To evaluate the CT imaging changes and the curative effect of advanced lung cancer before and after conseivative treatment. Methods 40 cases of advanced lung cancer （ including Ⅲ b 24 cases, Ⅳ stage 16 cases）, taking TP chemotherapy combined with Shenqi Fuzheng injection treatment,21 days for a cycle,respectively,before treatment and treatment after 2 cycles （CEA） and cancer antigen 125 （CA125） were used to evaluate the effect of CT and imaging. Results The mean diameter of the tumors before and after treatment were （4.16 ± 0.72） cm and （3.26 ± 0.25 ） cm, respectively, the difference was statistically significant （ t = 7. 823, P 〈 0.05 ）. After 2 cycles of treatment, CT examination showed that the primary lesion in the lungs was reduced, the hilar lymph nodes were significantly reduced, and the lung metastases disappeared. （ 36.33 ± 9.25） μg/L （P〈0.05）. The level of CEA and CA125 in stage Ⅲb group were significantly higher than those ofgroup Ⅲb （ 38.03 ±8.83 ）μg / L, （ 31.08 ±8.77 ） U / ml, lower than the group Ⅳ （ 37.66 ± 9.41 ） U / ml （ P 〈 0.05 ）. The rate of remission （66.67%） in group Ⅲb was higher than that of group IV （31.25%） （P 〈0.05）. The MPFS of the group lllb was 13.64 months, and the MPFS was 9.27 months in the IV group. The difference was statistically significant （Log-rank χ^2 = 16.74, P 〈 0.05）. Conclusion Conservative treatment of patients with advanced lung cancer can achieve satisfactory curative effect and improve the remission rate of patients.