卵巢癌致恶性腹腔积液患者应用腹腔热灌注化疗后血清CEA、CA125水平变化

Analysis of serum CEA and CA125 levels in patients with malignant ascites caused by ovarian cancer after intraperitoneal hyperthermic perfusion chemotherapy

目的探讨卵巢癌致恶性腹腔积液患者应用腹腔热灌注化疗的疗效及对血清癌胚抗原(CEA)、糖链抗原12.5(CA125)水平变化的影响。方法选取2017年3月-2019年3月南阳市中心医院收治的62例晚期卵巢癌患者,采用随机数字表法分为观察组和对照组,各31例。对照组接受单纯腹腔灌注化疗,观察组接受腹腔热灌注化疗。比较两组患者的治疗效果与症状改善指标。结果两组腹腔灌注化疗耐受程度佳所占比例差异无统计学意义(P>0.05)。观察组治疗总有效率61.2.9%,高于对照组的32.2.6%,差异有统计学意义(P<0.05)。治疗后,观察组患者的生存质量卡氏行为状态(KPS)评分(81.2.8±7.82)分,高于对照组的(71.03±8.2.3)分,差异有统计学意义(P<0.05)。两组治疗前血清CEA、CA125、CD4^(+)、CD8^(+)水平与CD4^(+)/CD8^(+)比较差异均无统计学意义(P>0.05);治疗后,观察组血清CEA、CA125水平低于对照组,CD8^(+)指标水平低于对照组,CD4^(+)与CD4^(+)/CD8^(+)水平高于对照组,差异均有统计学意义(P<0.05)。治疗期间,观察组出现肝功能减退、恶心呕吐、骨髓移植等不良反应发生率41.94%,与对照组的45.16%比较,差异无统计学意义(χ^(2)=0.211,P=0.646)。两组患者随访1年,观察组的生存率90.32%,与对照组的87.10%比较,差异无统计学意义(χ^(2)=0.161,P=0.688)。结论腹腔热灌注化疗可改善卵巢癌致恶性腹腔积液患者的免疫功能,提高患者的生存质量。

Objective To investigate the efficacy of intraperitoneal hyperthermic perfusion chemotherapy in patients with malignant ascites caused by ovarian cancer and its effect on serum carcino-embryonic antigen(CEA)and carbohydrate antigen 125(CA125)levels.Methods A total of 62 patients with advanced ovarian cancer admitted to the Nanyang City Center Hospital between March 2017 and March 2019 were enrolled.The random number table method was used to divide patients into observation group and control group,31 cases each.Patients in the control group received simple intraperitoneal infusion chemotherapy,and the patients in the observation group received intraperitoneal hyperthermic perfusion chemotherapy.The therapeutic effects and symptom improvement indicators of the two groups were compared.Results There was no statistically significant difference between the two groups in the proportion of better tolerance to intraperitoneal perfusion chemotherapy(P>0.05).The total effective rate of the observation group was 61.29%,which was significantly higher than that of the control group(32.26%)(P<0.05).After treatment,the quality of life karnofsky performance status(KPS)score(81.28±7.82)in the observation group was significantly higher than that in the control group(71.03±8.23)(P<0.05).There was no significant difference in the levels of serum CEA,CA125,CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)between the two groups before treatment(P>0.05).After treatment,the levels of serum CEA and CA125 in the observation group were significantly lower than those in the control group(P<0.05),the level of CD8^(+)in the observation group was significantly lower than that in the control group(P<0.05);the levels of CD4^(+)and CD4^(+)/CD8^(+)were significantly higher than those in the control group(P<0.05).During the treatment period,the incidence of adverse reactions such as liver dysfunction,nausea and vomiting,and bone marrow transplantation was 41.94%in the observation group,compared with 45.16%in the control group;the difference was not statistically significant(χ^(2)=0.211,P=0.646).The patients in the two groups were followed up for 1 year.The survival rate of the observation group was 90.32%,compared with 87.10%in the control group,the difference was not statistically significant(χ^(2)=0.161,P=0.688).Conclusion Intraperitoneal hyperthermic perfusion chemotherapy could improve the immune function of patients with malignant ascites caused by ovarian cancer and improve the quality of life of patients.