血清肿瘤标志物对胃癌化疗患者治疗效果的评价作用

Significance of serum tumor markers in predicting the therapeutic efficacy of chemotherapy for gastric cancer

目的探讨血清肿瘤标志物对胃癌患者化疗效果的评价作用。方法选取2015年1月至2017年12月间陕西省西安市第一医院收治的行化疗治疗的80例胃癌患者作为研究对象,所有患者均采用奥沙利铂联合卡培他滨进行化疗,并于化疗治疗前后进行血清肿瘤标志物检测。肿瘤标志物包括糖类抗原199(CA199)、糖类抗原125(CA125)、癌胚抗原(CEA)、糖类抗原724(CA724)和甲胎蛋白(AFP)。根据实体瘤疗效标准评价患者化疗后实体瘤的近期疗效,并评价化疗前与化疗后各项肿瘤标志物的变化、不同疗效患者化疗前后各项肿瘤标志物的情况。同时,随访1年,比较复发与未复发患者各项肿瘤标志物的情况。结果胃癌患者化疗后,完全缓解(CR) 6例,部分缓解(PR) 28例,疾病稳定(SD) 30例,疾病进展(PD) 16例。胃癌患者化疗治疗前后的CA199、CA125、CEA、CA724和AFP指标比较,差异无统计学意义(均P> 0. 05)。CR与PR患者化疗后的CA199、CA125、CEA、CA724和AFP指标均低于化疗前,差异均有统计学意义(均P <0. 05)。SD患者化疗前后的CA199、CA125、CEA、CA724和AFP指标比较,差异均无统计学意义(均P>0. 05)。PD患者化疗后CA199、CA125、CEA、CA724和AFP指标均高于化疗前,差异均有统计学意义(均P <0. 05)。随访1年,复发患者CA199、CA125、CEA、CA724和AFP指标均高于未复发患者,差异均有统计学意义(均P <0. 05)。结论血清肿瘤标志物CA199、CA125、CEA、CA724和AFP指标对胃癌患者化疗效果有一定的预测价值,能够为进一步制定临床治疗方案提供可靠的参考。

Objective To investigate the significance of serum tumor markers in predicting the therapeutic efficacy of chemotherapy for gastric cancer.Methods Eighty patients with gastric cancer who received chemotherapy at Xi’an First Hospital from January 2015 to December 2017 were selected as the study subjects.All patients were treated with oxaliplatin combined with capecitabine.Serum tumor markers were detected including carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),carbohydrate antigen 724(CA724)and alpha-fetoprotein(AFP)before and after chemotherapy.According to the response evaluation criteria in solid tumors(RECIST),the short-term treatment efficacy was evaluated in patients with solid tumors after chemotherapy.The changes in tumor markers before and after chemotherapy,and the situation of tumor markers were also evaluated in patients with different therapeutic effectiveness before and after chemotherapy.At the same time,after 1-year of follow-up,the tumor markers were compared between relapsed and non-relapsed patients.Result After the chemotherapy,complete remission(CR)was achieved in 6 patients,partial remission(PR)in was achieved in 28 patients,stable disease(SD)was achieved in 30 patients and progressive disease(PD)was achieved in 16 patients.There was no significant difference in CA199,CA125,CEA,CA724 and AFP between the two groups before and after chemotherapy(all P>0.05).The indexes of CA199,CA125,CEA,CA724 and AFP in CR and PR patients after were lower chemotherapy than before chemotherapy(all P<0.05).There was no significant difference in the indexes of CA199,CA125,CEA,CA724 and AFP in SD patients before and after chemotherapy(all P>0.05).In PD patients,the indexes of CA199,CA125,CEA,CA724 and AFP were higher after chemotherapy than before chemotherapy(all P<0.05).After following-up of 1 year,the CA199,CA125,CEA,CA724 and AFP indexes were higher in relapsed patients than in non-relapsed patients(all P<0.05).Conclusion:The serum tumor markers CA199,CA125,CEA,CA724 and AFP have certain predictive value for the chemotherapy treatment in patients which gastric cancer,and can provide reliable reference for the further development of clinical treatment programs.