新辅助化疗对晚期非小细胞肺癌患者疗效及血清学指标影响的研究

The effect of neoadjuvant chemotherapy on the efficacy and serological markers in patients with advanced non-small cell lung cancer

目的探究新辅助化疗对晚期非小细胞肺癌患者的疗效及相关血清学指标的影响。方法回顾性分析300例晚期非小细胞肺癌患者的病历资料,依据治疗方法不同将患者分为观察组150例和对照组150例。观察组患者接受术前新辅助化疗联合手术治疗,对照组患者直接进行手术治疗。比较两组患者治疗前后癌胚抗原(CEA)水平、糖类抗原125(CA125)水平、糖类抗原15-3(CA15-3)水平、糖类抗原19-9(CA19-9)水平、淋巴结R0及R1切除率、手术时间、术中出血量、术后引流管留置时间、术后并发症的发生情况及远期疗效。结果观察组患者的R0切除率高于对照组,差异有统计学意义(P﹤0.05)。两组患者的手术时间、术中出血量、术后引流管留置时间比较,差异均无统计学意义(P﹥0.05)。治疗前,两组患者的CEA、CA125、CA15-3、CA19-9水平比较,差异均无统计学意义(P﹥0.05);治疗后,观察组患者的CEA、CA125、CA15-3水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者术后感染、胸腔积液、胸腔积气的发生率比较,差异均无统计学意义(P﹥0.05)。观察组患者1年复发率低于对照组,1年生存率高于对照组,差异均有统计学意义(P﹤0.05)。结论晚期非小细胞肺癌患者接受新辅助化疗可以提高R0切除率,降低血清肿瘤标志物水平,提高术后1年生存率,且未增加术后并发症的发生率。

Objective To explore the effect of neoadjuvant chemotherapy on the efficacy and serological markers in patients with advanced non-small cell lung cancer（NSCLC）. Method 300 patients with advanced NSCLC were included in the study as study group（n=150） or control group（n=150） according to respective treatment administered. The patients in study group were given neoadjuvant chemotherapy combined with surgery; and those in control group were administered with surgery directly. The carcinoembryonic antigen（CEA）, carbohydrate antigen 125（CA125）, CA15-3,CA19-9, R0 and R1 resection rate of lymph node, operative time, intraoperative blood loss, time for indwelling chest tube, postoperative complications, and long-term efficacy of the two groups were compared. Result The R0 resection rate of study group was higher than that of the control group（P0.05）. As for the operative time, intraoperative blood loss, and time for indwelling chest tube, no significant difference was observed between the two groups（P0.05）. There was no significant difference in the levels of CEA, CA125, CA15-3 and CA19-9 between the two groups before treatment（P0.05）; after treatment, CEA, CA125, and CA15-3 levels were lower in study group than that in control group（P0.05）. There was no significant difference in the incidence of postoperative infection, pleural effusion and pneumothorax between the two groups（P0.05）. The 1-year recurrence rate was lower, while the 1-year survival rate was higher in study group than that in control group, the difference was statistically significant（P0.05）. Conclusion For patients with advanced non-small cell lung cancer, neoadjuvant chemotherapy can significantly increase the R0 resection rate, reduce the level of serum tumor markers, and improve 1-year survival after surgery, while not increase the incidence of postoperative complications.