不同类型CRS术联合新辅助化疗对晚期卵巢癌预后及肿瘤标志物的影响研究

Effect of Different Types of CRS Surgery Combined with Neoadjuvant Chemotherapy on the Prognosis and Tumor Markers of Advanced Ovarian Cancer

目的分析不同类型的细胞减灭术(cytoreductive surgery,CRS)联合新辅助化疗(neoadjuvant chemotherapy,NACT)对晚期卵巢癌的效果。方法选择2017年3月—2021年3月京山市人民医院诊治的60例晚期卵巢癌患者,按照随机排列表法分为两组,对照组(30例)采用初始CRS联合NACT治疗,观察组(30例)采用间歇性CRS联合NACT治疗。比较两组近期效果、手术相关指标、肿瘤标志物、随访3年的生存率、不良反应发生情况。结果观察组的总有效率为96.67%高于对照组的73.33%,差异有统计学意义(χ^(2)=4.706,P=0.030);两组患者手术时间比较,差异无统计学意义(P>0.05);观察组的术中失血量、住院时间、腹腔积液量均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组的HE4、VEGF、CA125指标均低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05);观察组随访1年、2年、3年的生存率均高于对照组,差异有统计学意义(P<0.05)。结论不同类型的CRS联合NACT可彻底切除病变组织,能够降低机体内肿瘤的体积,控制肿瘤侵犯范围,改进手术效果,同时还能减少不良反应的发生,提升生存率。

Objective To analyze the effect of different types of cytoreductive surgery(CRS)combined with neoadjuvant chemotherapy(NACT)on advanced ovarian cancer.Methods Sixty patients with advanced ovarian cancer diagnosed and treated at the People's Hospital of Jingshan City from March 2017 to March 2021 were randomly divided into two groups.The control group(30 cases)received initial CRS combined with NACT treatment,while the observation group(30 cases)received intermittent CRS combined with NACT treatment.Compared the recent outcomes,surgical related indicators,tumor markers,3-year follow-up survival rate,and incidence of adverse reactions between the two groups.Results The total effective rate of the observation group was 96.67%,which was higher than 73.33%of the control group,the difference was statistically significant(χ^(2)=4.706,P=0.030).There was no statistically significant difference in surgical time between the two groups of patients(P>0.05).The intraoperative blood loss,hospital stay,and abdominal fluid accumulation in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).After treatment,the HE4,VEGF,and CA125 indicators in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The survival rates of the observation group at 1 year,2 years,and 3 years of follow-up were higher than those of the control group,the difference was statistically significant(P<0.05).Conclusion The combination of different types of CRS and NACT can completely remove diseased tissue,reduce the volume of tumors in the body,control the extent of tumor invasion,and improve surgical effectiveness.At the same time,it also reduces the occurrence of adverse reactions and improves survival rate.