术中植入氟尿嘧啶缓释剂对进展期结直肠癌患者血清CEA、CA199的影响

目的观察术中植入氟尿嘧啶缓释剂对结直肠癌患者血清肿瘤标记物癌胚抗原（CEA）、肿瘤抗原（CA199）的影响,评估其临床疗效。方法将2009年6月至2010年4月经根治手术切除的DukesB-C期结直肠癌44例随机分成两组,各22例。治疗组：行根治性手术中植入氟尿嘧啶缓释剂600-1000mg,术后2周予以常规静脉化疗;对照组：术中未植入氟尿嘧啶缓释剂,术后2周予以同一方案化疗。所有病人分别于术前1d和术后第14天、第42天采血,采用电化学发光法测定血清中CEA、CA199。结果 （1）术前治疗组的CEA、CA199与对照组的比较,无显著差异（P〉0.05）;（2）术后第14天治疗组的上述血清肿瘤标记物水平明显低于对照组的（P〈0.05）;（3）术后第42天治疗组的上述血清肿瘤标记物水平与对照组基本相似（P〉0.05）;（4）治疗组的术后第14天CEA降幅明显大于对照组的（P〈0.05）。结论术中植入氟尿嘧啶缓释剂能够提前降低结直肠癌患者血清CEA、CA199水平,起到很好的化疗效应。

Effect of implantation of sustained-release fluorouracil on the level of serum CEA and CA199 during the operation for the advanced colorectal cancer

Objective To observe the effect of implantation of sustained-release fluorouracil on the level of serum CEA and CA 199 during the operation for the advanced colorectal cancer.Methods 44 cases of Dukes B-C stage colorectal cancer which accepted radical operation from June 2009 to April 2010 were randomly divided into 2 groups.The patients in experimental group were implanted with 600-1 000 mg of sustained-release fluorouracil to suspecting regions after radical operation.Regular chemotherapy was given to them 2 weeks after operation,and the control group received only operation.All patients were respectively adopted 2 ml peripheral blood on the 1day before op-eration,14 days and 42 days after operation,and then detected CEA,CA 199 by electro-chemiluminescence.Results 1.There was no significance of CEA and CA 199 between the experimental group and control group before operation.2.The levels of CEA and CA 199 in the experimental group were significantly lower than those in control group 14 days after operation（P0.05）.3.There was no significance between the levels of CEA and CA 199 in the experimental group and control group 42 days after operation.Conclusion Implantation of sustained-release fluorouracil during operation can decrease the level of serum CEA and CA 199 in the advanced colorectal cancer,and achieve commendable chemotherapy effect.