血清同型半胱氨酸对培美曲塞治疗晚期肺腺癌疗效的预测作用

目的探讨血清Hcy水平变化在肺腺癌患者采用培美曲塞化疗疗效预测中的作用。方法回顾性分析肺腺癌采用培美曲塞化疗患者57例,分别于化疗前和化疗2个周期结束后,清晨空腹抽取静脉血检测Hcy水平,对患者临床特征、化疗前后Hcy水平及其变化与临床疗效的关系进行统计学分析。结果根据治疗过程中的影像学检查结果,评价治疗疗效为:完全缓解(CR)0例、部分缓解(PR)19例、稳定(SD)22例、进展(PD)16例,客观有效率(ORR)为33.3%,疾病控制率(DCR)为71.9%,不同临床因素对培美曲塞疗效无显著影响(P0.05)。比较Hcy水平及Hcy水平变化对培美曲塞疗效的影响,结果显示治疗前血清Hcy水平的高低对疗效无明显影响,治疗后血清Hcy水平正常者DCR明显高于血清Hcy水平异常者,化疗后Hcy水平降低患者ORR及DCR均明显高于血清Hcy水平升高患者(P0.05)。结论肺腺癌患者采用培美曲塞化疗过程中监测血清Hcy水平的变化,有可能用于肺腺癌患者化疗疗效预测。

Predictive role of serum Hcy levels in effect of advanced lung adenocarcinoma treated with PEM

Objective To study the role of serum Hcy level change in predicting the effects of pemetrexed (PEM ) chemotherapy for treating the patients with advanced lung adenocarcinoma .Methods Fifty‐seven cases of lung adenocarcinoma treated by the PEM chemotherapy were retrospectively analyzed .The fasting venous blood was collected for detecting serum Hcy level before chemotherapy and at the end of 2‐week chemotherapy .The clinical characteristics ,Hcy level before and after chemotherapy and the relation between the Hcy level with clinical effect were statistically analyzed .Results In the therapeutic effects evaluated by the im‐aging examination during treatment process ,there were no case of complete remission (CR) ,19 cases of partial remission (PR) ,22 cases of stable diseases(SD) and 16 cases of progressed diseases(PD) ,the objective response rate(ORR) was 33 .3% and disease control rate (DCR) was 71 .9% .Different clinical factors had no significant influence on the efficacy of PEM chemotherapy (P>0 .05) .In comparing the influence of Hcy level and Hcy level change on the effect of PEM chemotherapy ,the results showed that serum Hcy level before treatment had no obvious influence on curative effect ,DCR in the patients with normal serum Hcy level after treatment was significant higher than that with abnormal Hcy level ,ORR and DCR in the patients with decreased Hcy level after chemotherapy were significantly higher than those with increased Hcy level (P<0 .05) .Conclusion Monitoring the serum Hcy lev‐el change during the PEM chemotherapeutic process in the patients with advanced lung adenocarcinoma may be used in the predic‐tion of the chemotherapeutic effect .