原代肿瘤细胞化疗药物敏感性检测指导下治疗对晚期癌症患者生存预后及肿瘤标志物的影响

Effects of primary tumor cell chemotherapeutic drug sensitivity detection guided treatment on survival prognosis and tumor markers in advanced cancer patients

目的探讨原代肿瘤细胞化疗药物敏感性检测指导下治疗对晚期癌症患者生存预后及肿瘤标志物的影响。方法以2022年1月至2023年4月在华南大学第一附属医院就诊的107例晚期癌症患者为研究对象,按不同化疗方案分为观察组(n=41例)和对照组(n=66例)。观察组:原代肿瘤细胞化疗药物敏感性检测指导下进行化疗;对照组:接受FOLFOX4(奥沙利铂+5⁃氟尿嘧啶+亚叶酸钙)方案化疗,随访12个月。比较两组完全缓解(CR)、部分缓解(PR)、稳定性疾病(SD)、病情进展(PD),计算有效缓解率(ORR)和疾病控制率(DCR);比较两组肿瘤标志物[鳞状上皮细胞癌抗原(SCC)、癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白片段19(CYFRA21⁃1)];采用Kaplan⁃Meier生命曲线进行生存分析。结果观察组ORR率与DCR率均显著高于对照组,差异有统计学意义(P<0.05)。经治疗,两组血清SCC、CEA、CA125与CYFRA21⁃1水平均相应下降(P<0.05),且观察组低于对照组,差异有统计学意义(P<0.05)。Kaplan⁃Meier生命曲线分析结果显示,观察组PFS、OS与对照组比较差异有统计学意义(P<0.05)。结论原代肿瘤细胞化疗药物敏感性检测指导下治疗晚期癌症,改善患者预后,对癌症晚期个体化治疗方案具有一定的指导价值。

Objective To investigate the effects of primary tumor cell chemotherapy drug sensitivity detection on survival prognosis and tumor markers in advanced cancer patients.Methods A total of 107 patients with advanced cancer were treated at the First Affiliated Hospital of South China University from January 2022 to April 2023.They were divided into an observation group and a control group based on different chemotherapy regimens.The observation group consisted of 41 cases,where primary tumor cells were subjected to chemotherapy drug sensitivity detection under the guidance of chemotherapy.The control group included 66 patients who received the FOLFOX4 regimen(oxaliplatin+5⁃fluorouracil+calcium folinate)and were followed up for 12 months.The study observed the complete response(CR),partial response(PR),stable disease(SD)and disease progression(PD)of both groups.It also calculated and compared the effective response rate(ORR)and disease control rate(DCR).Additionally,tumor markers(squamous cell carcinoma antigen(SCC)),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and cytokeratin fragment 19(CYFRA21⁃1)were compared between the two groups.Kaplan⁃Meier life curve was used for survival analysis.Results The ORR rate and DCR rate in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).After treatment,serum levels of SCC,CEA,CA125,and CYFRA21⁃1 decreased in both groups(P<0.05),with the observation group showing lower levels than the control group(P<0.05).Kaplan⁃Meier survival curve analysis showed that PFS and OS in the observation group were significantly different from those in the control group(P<0.05).Conclusion The treatment of advanced cancer guided by primary tumor cell chemotherapy drug sensitivity detection,can improve patients'prognosis and has a certain value in guiding individualized treatment for advanced cancer.