循环肿瘤DNA联合肿瘤标志物评估益气化瘀汤治疗分化型甲状腺癌患者疗效的临床研究

Circulating Tumor DNA Combined with Tumor Markers Evaluating Clinical Effect of Yiqi Huayu Decoction(益气化瘀汤)on Patients with Differentiated Thyroid Cancer

目的 探究循环肿瘤DNA(ctDNA)联合肿瘤标志物评估益气化瘀汤治疗分化型甲状腺癌患者疗效的临床研究。方法 以2019年1月—2021年1月68例分化型甲状腺癌患者为研究对象,均给予益气化瘀汤治疗。根据治疗2个月的临床疗效将患者分为显效组、有效组及无效组。比较3组ctDNA表达及癌胚抗原(CEA)、糖类抗原50(CA50)、糖类抗原125(CA125)水平,分析ctDNA表达与CEA、CA50、CA125水平的相关性及各指标联合检测对益气化瘀汤临床疗效的评估价值;根据肿瘤缓解情况分为肿瘤缓解组及未缓解组,比较两组ctDNA表达及CEA、CA50、CA125水平,分析其对肿瘤缓解情况的评估价值。结果 显效组、有效组、无效组治疗后ctDNA表达量及CEA、CA50、CA125水平均呈升高趋势(P<0.05);患者ctDNA表达量与CEA、CA50、CA125水平呈正相关(P<0.05);ctDNA表达量及CEA、CA50、CA125水平联合检测评估益气化瘀汤治疗分化型甲状腺癌临床疗效的AUC高于各指标单独检测(P<0.05);缓解组治疗后ctDNA表达量及CEA、CA50、CA125水平均高于未缓解组(P<0.05);ctDNA表达量及CEA、CA50、CA125水平联合检测评估益气化瘀汤治疗分化型甲状腺癌肿瘤缓解情况的AUC高于各指标单独检测(P<0.05)。结论 tDNA联合肿瘤标志物对益气化瘀汤治疗分化型甲状腺癌患者疗效及对肿瘤的缓解效果具有评估价值。

Objective To explore the clinical study of circulating tumor DNA(ctDNA)combined with tumor markers in the evaluation on curative effect of Yiqi Huayu Decoction(益气化瘀汤)on patients with differentiated thyroid cancer.Methods A total of 68 patients with differentiated thyroid cancer were enrolled as the research objects between January 2019 and January 2021.All were treated with Yiqi Huayu Decoction.According to clinical curative effect after 2 months of treatment,they were divided into markedly effective group,effective group and ineffective group.The expression of ctDNA,levels of carcinoembryonic antigen(CEA),carbohydrate antigen 50(CA50)and carbohydrate antigen 125(CA125)were compared among the three groups.The correlation between ctDNA expression and levels of CEA,CA50 and CA125,and the value of their combined detection for clinical curative effect of Yiqi Huayu Decoction were analyzed.According to tumor remission,they were divided into remission group and non-remission group.The ctDNA expression,levels of CEA,CA50 and CA125 between the two groups were compared,and their evaluation value for tumor remission was analyzed.Results The expression of ctDNA,levels of CEA,CA50 and CA125 in the markedly effective group,effective group and ineffective group were increased in turn after treatment(P<0.05).The expression level of ctDNA was positively correlated with levels of CEA,CA50 and CA125(P<0.05).AUC of ctDNA combined with CEA,CA50 and CA125 for evaluating clinical curative effect of Yiqi Huayu Decoction on differentiated thyroid cancer was greater than that of single index(P<0.05).After treatment,the expression of ctDNA,levels of CEA,CA50 and CA125 in the remission group were higher than those in the non-remission group(P<0.05).AUC of ctDNA combined with CEA,CA50 and CA125 for evaluating tumor remission was greater than that of single index(P<0.05).Conclusion The ctDNA combined with tumor markers is of evaluation value for curative effect of Yiqi Huayu Decoction on differentiated thyroid cancer and tumors remission.