125I粒子植入治疗非小细胞肺癌前后CEA、CYFRA21-1变化与临床疗效评价

目的评估125I粒子植入联合支气管动脉灌注化疗治疗中晚期非小细胞肺癌(NSCLC)患者前后癌胚抗原(CEA)及细胞角蛋白19片段(CYFRA21-1)水平变化及临床疗效。方法回顾性分析87例中晚期NSCLC患者的临床资料,根据治疗方法的不同分为两组联合组42例行125I粒子植入联合支气管动脉灌注术,灌注组45例行支气管动脉灌注化疗术,比较两组血清CEA、CYFRA21-1浓度的动态变化及对临床治疗效果的影响。结果联合组和灌注组术后1、3、6、12月缓解率分别为14.3%、54.7%、66.6%、72.2%和8.8%、28.8%、38.6%、39.3%,联合组缓解率高于灌注组,术后两组CEA及CYFRA21-1浓度均较术前下降,联合组血清CEA及CYFRA21-1浓度低于灌注组(P<0.05)。联合组及灌注组中位生存时间分别为20个月和15个月,中位无进展生存时间分别为11个月和7个月,联合组生存率显著高于灌注组(χ^2=11.028,P=0.001),差异有统计学意义。术后血清CEA和CYFRA21-1降低组有效率及生存率均明显高于CEA和CYFRA21-1增高组(P<0.05)。结论125I粒子植入联合支气管动脉灌注化疗治疗中晚期NSCLC疗效确切,可有效降低患者血清中CEA、CYFRA21-1的浓度,且CEA、CYFRA21-1的动态变化可预测患者的预后。

The clinical efficacy of 125I seed implantation in the treatment of non-small cell lung cancer and the changes of CEA and CYFRA21-1 before and after treatment

Objective To assess the clinical efficacy of 125I seed implantation combined with bronchial artery infusion chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC)and the changes of carcinoembryonic antigen(CEA)and cytokerantin-19-fragment(CYFRA21-1)before and after treatment.Methods The clinical data of a total of 87 of pathologically confirmed advanced NSCLC were retrospectively analyzed.According to the therapeutic method,patients were divided into the combination treatment group(n=42,treated with bronchial artery perfusion combined with 125I seed implantation)and perfusion group(n=45,treated with bronchial artery perfusion chemotherapy alone).The dynamic changes of CEA and CYFRA21-1 levels before and after treatment and their effects on clinical efficacy were compared between the two groups.Results The effective rates at 1,3,6 and 12 months after operation of the combined treatment group and the control group were 14.3%,54.7%,66.6%,72.2%and 8.8%,28.8%,38.6%and 39.3%respectively.The effective rates of the combined group were higher than those of the simple perfusion chemotherapy group.The levels of CEA and CYFRA21-1 in the two groups after the operation were both lower than those before the operation,while,the concentrations of CEA and cyfra21-1 in the combined group were lower than those of the perfusion group(P<0.05).The median survival time of the combined group and the perfusion group was 20 months and 15 months respectively,and the median progression free survival time was 11 months and 7 months respectively.The survival rate of the combined group was significantly higher than that of the perfusion group(χ^2=11.028,P=0.001).The difference between the two groups was statistically significant.Serum CEA and CYFRA21-1 decreased group had significantly higher effective rate and overall survival rate than increased group(P<0.05).Conclusion 125I seed implantation combined with bronchial artery infusion chemotherapy is effective in the treatment of advanced NSCLC.It can effectively reduce the concentration of CEA and CYFRA21-1 in serum,and the dynamic changes of tumor markers can predict the prognosis of patients.