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1.
目的 探讨肿瘤靶向治疗药物恩度联合放化疗治疗初诊晚期非小细胞肺癌的优势,寻找一种治疗晚期非小细胞肺癌有效的治疗组合模式,提高晚期肺癌患者的生存率及生存质量.方法 将2009年7月至2010年2月收住的18例初诊为晚期非小细胞肺癌患者随机分为实验组(含恩度)和对照组(不含恩度)各9例,采用诱导化疗并三维适形放疗,观察2组患者治疗的临床症状缓解率、疗效、不良反应,同时做好放化疗及靶向治疗的护理.结果 实验组及对照组的疗效分别为77.8%和66.7%,实验组的临床症状缓解率与对照组比较无显著差异,2组患者均有不同程度的不良反应,在护理人员的整体护理和系统健康教育下,均顺利完成治疗.结论 恩度联合放化疗治疗初诊晚期非小细胞肺癌,能提高疗效及生存率,改善生活质量,虽有一定的不良反应,但经对症处理及护理能缓解.
Abstract:
Objective To study in targeted therapy of cancer drug endostar combined with radiotherapy and chemotherapy in the treatment of newly diagnosed patients with advanced non-small cell lung cancer, and find an effective combined treatment mode of advanced non-small cell lung cancer, so as to improve the survival rate and quality of life of patients with advanced lung cancer. Methods 18 patients with newly diagnosed advanced non- small cell lung cancer admitted to our hospital from July 2009 to February 2010 were randomly divided into 2 groups and treated with induction chemotherapy and 3D-CRT,9 cases in the experimental group (including Endostar), 9 cases in the control group, All of the patients'clinical symptoms, efficacy and toxicity in the two groups were observed. At the same time, nursing of radiotherapy, chemotherapy and targeted therapy was given to paients. Results The efficacy of the experimental group and the control group were 77.8% and 66.7%, the clinical remission rates of the experimental group and the control group showed no significant difference, both of the patients in the two groups had varying degrees of toxicity, but all of the them completed the treatment well under the holistic nursing and systematical health education by nurses. Conclusions Endostar combined with induction chemotherapy and three-dimensional conformal radiotherapy (3D-CRT) in the treatment of advanced non-small cell lung cancer can improve the efficacy and survival rate, and the quality of life, although there are some side effects, but can be alleviated by symptomatic treatment and care.  相似文献   

2.
Objective To explore the correlation between Cyfra21-1、 NSE、 CEA、CA125 and the bone metastasis in lung cancer.Methods Images were obtained on a gamma camera (E.CAM,Siemens,Erlangen,Germany)using 99mTC-MDP as a skeletal imaging agent.67 cases diagnosed as lung cancer were performed by ECT bone imaging,serum concentration of Cyfra21-1,NSE,CEA and CA125 were measured among 30 healthy individual,33 patients with pulmonary tuberculosis and 67 patients with lung cancer by electrogenerated chemiluminescence(ECL) (Roche,Germany).Results The serum Cyfra21-1、NSE、CEA、CA125 from lung cancer were higher than that of controls group and pulmonary tuberculosis group(P<0.01).and the pleural Cyfra21-l and NSE were significantly higher than that in serum.In lung cancer,there are correlation between tumor marker and its pathological types.Cyfra21-1 concentration in squamous cell carcinoma were significantly higher than that of other lung cancers(P<0.01),NSE level in small cell lung cancer were significantly higher than that other lung cancers(P<0.01).33 patients with lung cancer had no obvious sign of bone metastases among 67 cases (accounting for 49.3%),34 patients had bone metastases with varying degrees(accounting for 50.7 % ) ;Adenocarcinoma has highest incidence of bone metastasis( 64 % ),followed by small cell lung cancer and squamous cell carcinoma.Cyfra21-land NSE level is highest in cases with wide spread bone metastasis,followed by those with part bone metastasis and without bone metastasis in turn.Conclusion There are relationship between tumor marker and bone metastasis of lung cancer.Multiple bone metastases often were accompanied by obvious change of serum tumor marker.Cyfra21-lis a useful tool in diagnosis of non-small cell lung cancer,especially in squamous cell carcinoma.NSE is useful to identify the small cell lung cancer.Combined determination of Cyfra21-1,NSE,CEA and CA125 can improve sensitivity,accuracy and positive rate of diagnosis lung cancer.It seems that the whole body bone imaging combined Cyfra21-1,NSE,CEA and CA125 detection have important clinical value in diagnosis and identification of lung cancer.  相似文献   

3.
Objective To explore the correlation between Cyfra21-1、 NSE、 CEA、CA125 and the bone metastasis in lung cancer.Methods Images were obtained on a gamma camera (E.CAM,Siemens,Erlangen,Germany)using 99mTC-MDP as a skeletal imaging agent.67 cases diagnosed as lung cancer were performed by ECT bone imaging,serum concentration of Cyfra21-1,NSE,CEA and CA125 were measured among 30 healthy individual,33 patients with pulmonary tuberculosis and 67 patients with lung cancer by electrogenerated chemiluminescence(ECL) (Roche,Germany).Results The serum Cyfra21-1、NSE、CEA、CA125 from lung cancer were higher than that of controls group and pulmonary tuberculosis group(P<0.01).and the pleural Cyfra21-l and NSE were significantly higher than that in serum.In lung cancer,there are correlation between tumor marker and its pathological types.Cyfra21-1 concentration in squamous cell carcinoma were significantly higher than that of other lung cancers(P<0.01),NSE level in small cell lung cancer were significantly higher than that other lung cancers(P<0.01).33 patients with lung cancer had no obvious sign of bone metastases among 67 cases (accounting for 49.3%),34 patients had bone metastases with varying degrees(accounting for 50.7 % ) ;Adenocarcinoma has highest incidence of bone metastasis( 64 % ),followed by small cell lung cancer and squamous cell carcinoma.Cyfra21-land NSE level is highest in cases with wide spread bone metastasis,followed by those with part bone metastasis and without bone metastasis in turn.Conclusion There are relationship between tumor marker and bone metastasis of lung cancer.Multiple bone metastases often were accompanied by obvious change of serum tumor marker.Cyfra21-lis a useful tool in diagnosis of non-small cell lung cancer,especially in squamous cell carcinoma.NSE is useful to identify the small cell lung cancer.Combined determination of Cyfra21-1,NSE,CEA and CA125 can improve sensitivity,accuracy and positive rate of diagnosis lung cancer.It seems that the whole body bone imaging combined Cyfra21-1,NSE,CEA and CA125 detection have important clinical value in diagnosis and identification of lung cancer.  相似文献   

4.
Objective To investigate the diagnostic value of Joint determination of CEA,NSE and CYFRA21-1 in serum from patients with lung cancer.Methods Detected the CEA、NSE、CYFRA21-1 in different type patients with lung cancer.Results In lung cancer group,the levels of CEA,NSE and CYFRA21-1 were significantly higher than those group of benign lung disease (P<0.05).The sensitivity of joint measurement CEA,NSE and CYFRA21-1 was significantly higher than that of each tumor marker(P<0.05).Conclusion Joint measurement of CEA,NSE and CYFRA21-1 is helpful to diagnosis of lung cancer.  相似文献   

5.
Objective To investigate the diagnostic value of Joint determination of CEA,NSE and CYFRA21-1 in serum from patients with lung cancer.Methods Detected the CEA、NSE、CYFRA21-1 in different type patients with lung cancer.Results In lung cancer group,the levels of CEA,NSE and CYFRA21-1 were significantly higher than those group of benign lung disease (P<0.05).The sensitivity of joint measurement CEA,NSE and CYFRA21-1 was significantly higher than that of each tumor marker(P<0.05).Conclusion Joint measurement of CEA,NSE and CYFRA21-1 is helpful to diagnosis of lung cancer.  相似文献   

6.
李亮  王俊和 《华西医学》2010,(1):241-243
肺癌肿瘤抑制物1(tumor suppressor in lung cancer 1,TSLC1)是由Gomyo等分析人类染色体11q23.2区域时发现,并由Murakam通过功能忡互补的方法,将正常11号染色体长臂DNA片断转染到非小细胞肺癌(non-small cell lung cancer,NSCLC)细胞株A549,然后注入裸鼠体内,从而发现的一个新的肿瘤抑制基因。  相似文献   

7.
Objective To observe the pemetrexed treatment of advanced non-small cell lung cancer and toxicity, corresponding to explore nursing. Methods 32 cases of elderly patients with advanced non-small cell lung cancer patients were infused pemetrexed in order to evaluate efficacy, toxicity, and implement appropriate care measures. Results 32 patients with advanced non-small cell lung cancer patients with pemetrexed treatment, complete remission (CR) 2 patients and partial remission (PR) 17 cases, stable (SD) 6 cases and progress (PD)7 cases. Toxicity occurs mainly in bone marrow suppression, gastrointestinal reactions, allergic reactions and drug extravasation and so on. 2 cases Ⅱ myelosuppression, 1 Ⅳ myelosuppression; Ⅱ nausea and vomiting in 19 cases, 5 cases of mild constipation; 2 patients had severe skin itching. The effective symptomatic treatment and active care measures have been eased. Conclusion Pemetrexed treatment of advanced non-small cell lung cancer patients, master the correct method of administration, toxicity of timely symptomatic treatment and care interventions can improve the quality of life of patients.  相似文献   

8.
Objective To study the clinical singificance of serum tumor markers (CA153, CA125 and CEA) in doagnosis of breast cancer. Methods Electrochemiluminescence immunoassay (ECLIA) was used to analyze serum levels of CA153,CA125 and CEA in 55 patients with breast canc-er (breast cancer group),20 patients with benign breast lesions (benign breast lesion group) and 20 healthy controls (healthy control group). Results The levels of CA153, CA125 and CEA in breast cancer group were significantly higher than those in healthy control group (P<0.05); the levels of CEA and CA153 in breast cancer group were significantly higher than those in benign breast lesion group (P<0.05);the level of CA153 in postoperative patients was statistically lower than that in pre-operative patients (P<0.05);the levels of CEA and CA153 in breast cancer patients with stage Ⅲ and Ⅳ were significantly higher than those in healthy controls (P<0.05); the level of CA153 with stage Ⅲ and Ⅳ was higher than that in ones with stage Ⅰ and Ⅱ. The combined dection of CA153, CA125 and CEA in breast cancer patients increased the experimental sensitivity to 53.8% and specific-ity to 83.3%. Conclusion Detections of CA153,CA125 and CEA contribute to diagnosis of breast cancer. CA153 and CEA are of clinical practical value in differential diagnosis of benign and malignant breast tumor,monitoring of course of breast cancer.  相似文献   

9.
探讨热疗联合放疗和化疗治疗63例晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的临床疗效。  相似文献   

10.
凡国华  孙静云  赵蕾   《护理与康复》2018,17(9):42-44
正近年来,肺癌一直位居世界癌症死因的前列~([1]),我国肺癌发病率和病死率均居恶性肿瘤的首位~([2]),根据肺癌的分化程度和形态特征,目前将肺癌分为小细胞肺癌(small cell lung cancer,SCLC)和非小细胞肺癌(non-small cell lung cancer,NSCLC)。NSCLC占肺癌患者的80%~90%~([3]),大多数就诊时已属晚期,失去了手术治疗的机会。  相似文献   

11.
目的探讨白细胞介素(interluekin,IL)-4基因多态性与非小细胞肺癌易感性的关系。方法采用PIRA-PCR分析的方法检测了235例非小细胞肺癌患者和216名正常对照者的IL-4T-168C(rs2070874)多态性,分析其基因型与非小细胞肺癌发病风险的相关性。结果在非小细胞肺癌患者中,TC基因型出现的频率(28.9%)明显低于正常对照组(37.5%)。TC基因型显著降低了非小细胞肺癌的易感性(OR=0.65.95%CI=O.47~0.97;P=O.04);非小细胞肺癌患者中携带c型等位基因的基因型(TC/CC)频率明显低于正常对照组中相应基因型的频率(64.3%VS73.5%;OR=o.64,95%CI=0.48---0.96;P=O.03)。结论IL.4T-168C(rs2070874)多态性可能与中国人群非小细胞肺癌的遗传易感性相关。  相似文献   

12.
目的探讨内科胸腔镜下胸膜活检术和肺部肿瘤标志物对不明原因胸腔积液的临床应用价值。方法回顾性分析该院2014年1月-2016年3月76例不明原因胸腔积液的患者,采用内科胸腔镜进行胸膜活检送病理,且在入院时即采集患者静脉血10 ml送检,查血清肿瘤标志物[癌胚抗原(CEA)、鳞状细胞癌抗原(SCC-Ag)、胃泌素释放肽前体(Pro GRP)、细胞角蛋白19片段(CYFRA21-1)]进行测定。结果 76例不明原因胸腔积液的患者中有良性病变32例(肺结核14例,炎性病变9例,肉芽肿性炎6例,脓胸2例,错构瘤1例);恶性病变44例(腺癌18例,鳞癌13例,小细胞肺癌6例,腺鳞癌3例,间皮瘤2例,大细胞癌1例,胸腺瘤1例)。检测血清肿瘤标志物发现,血清中CEA、SCC-Ag、Pro GRP、CYFRA21-1水平在恶性胸腔积液组与良性胸腔积液组之间差异具有统计学意义(P=0.021、P=0.006、P=0.003和P=0.010),恶性胸腔积液患者血清各项肿瘤标记物水平明显高于良性胸腔积液的患者。根据病理结果将44例恶性胸腔积液中非肺癌所致胸腔积液的患者剔除(即2例间皮瘤及1例胸腺瘤患者),将剩下的41例肺癌所致胸腔积液患者,根据病理类型分为非小细胞肺癌(NSCLC)与小细胞肺癌(SCLC)。分析结果显示CEA、Pro GRP和CYFRA21-1水平在NSCLC与SCLC中差异具有统计学意义(P=0.036,P=0.005,P=0.008),而SCC-Ag差异无统计学意义(P=0.811)。结论内科胸腔镜在不明原因胸腔积液中具有检出率高、准确性高的特点,尤其是对胸膜转移瘤的恶性胸积液的诊断具有重要的意义。但血清学指标可以在病理结果出来之前为医师提供重要的参考价值,是临床诊断肺癌所致恶性胸腔积液的一种重要的手段,值得在临床推广应用。  相似文献   

13.
目的 探讨影响晚期非小细胞肺癌预后的相关因素。方法 回顾性分析118例晚期非小细胞肺癌患者的临床资料,分析影响其预后的相关因素。结果 ①单因素分析:患者年龄37~79岁,中位值为60岁,低年龄组(≤60岁)和高年龄组(>60岁)中位生存期分别为641天和513天(P=0.015); 纤维蛋白原为1.99~9.99 g/L,中位值为4.00 g/L,低纤维蛋白原组(≤4.00 g/L)和高纤维蛋白原组(>4.00 g/L)中位生存期分别为692天和421天(P=0.005); 病理类型:腺癌、鳞癌、腺鳞癌中位生存期依次递减(P=0.020); PS评分越高,中位生存期越短(P=0.018); 性别、PLRNLR,T/N分期,CYFRA21-1,吸烟对晚期非小细胞肺癌患者生存时间的影响差异无统计学意义。②通过 Cox回归分析进行多因素分析,仅纤维蛋白原为影响晚期非小细胞肺癌预后的独立因素。结论 单因素分析显示年龄、纤维蛋白原、PS评分和病理类型对于晚期非小细胞肺癌预后有影响,且年龄、纤维蛋白原、PS评分与预后生存期呈负相关,腺癌的生存时间较鳞癌和腺鳞癌长; 多因素Cox分析提示纤维蛋白原是影响晚期非小细胞肺癌预后的独立危险因素,且纤维蛋白原越高,预后越差。  相似文献   

14.
[目的]研究外周静脉血循环肿瘤细胞(CTC)与非小细胞肺癌(NSCLC)患者临床特征的关系.[方法]选取本院2014年4月至2015年4月期间收治的50例NSCLC患者作为研究对象,另收集30例体检健康志愿者的资料以及36例良性肺部疾病患者的资料.采集上述各研究组静脉血的标本并检测静脉血中CTC的数量(阳性判断为测定结果CTC的数量≥8.7 CU),分析患者性别、年龄、临床分期以及病理类型与CTC计数之间的关系.[结果]CTC值水平呈现偏态分布.且NSCLC组的CTC值显著高于肺部良性病变组(t=62.865,P<0.01)以及健康对照组(t=86.710,P<0.01);初诊NSCLC患者全血CTC的数值与患者性别(t=1.581,P=0.177),年龄(t=-0.981,P=0.329)之间无显著性差异;NSCLC患者的不同病理类型之间的CTC数值比较差异无显著性(t=-1.341,P=0.186),而不同临床分期的患者之间的CTC值比较差异具有显著性(F=4.708,P=0.006).[结论]CTC计数与NSCLC患者的临床表现具有一定的相关性,在一定程度上可以初步反映NSCLC患者疾病状态.  相似文献   

15.
李冬  杨海山 《中国实验诊断学》2007,11(12):1618-1620
目的探讨非小细胞肺癌(NSCLC)组织中VEGF mRNA的表达特点。方法应用RT-PCR方法,检测56例非小细胞肺癌组织和10例良性肺肿瘤组织及正常肺组织的VEGF mRNA的表达情况,并分析其与病理特征之间的关系。结果VEGF mRNA在正常肺组织及良性肺肿瘤组织几乎无阳性表达,而在非小细胞肺癌中84.56%有阳性表达;VEGFmRNA在不同组织类型肿瘤中的表达无统计学差异;在临床分期III期的肿瘤中VEGFmRNA的表达量与临床分期II、I期的肿瘤相比明显过表达,两两组间对比存在统计学差异。结论VEGFmRNA在多数肺部恶性肿瘤中呈现阳性表达,且随肿瘤临床分期的增高而增高,与肿瘤的组织类型无关。  相似文献   

16.
目的 探讨血清癌胚抗原(CEA),细胞角蛋白19片段(CYFRA21-1),神经元特异性烯醇化酶(NSE)水平在肺癌诊断、分型中的应用价值。方法收集79例肺癌患者,75例肺部良性疾病患者和163例健康体检者的空腹血清,采用电化学发光法检测血清CEA,CYFRA21-1和NSE水平,比较三项指标在肺癌诊断中的敏感度、特异度及阳性率,并比较在发生转移和未发生转移的肺癌患者血清CEA,CYFRA21-1和NSE水平。结果 与健康组和肺部良性疾病患者组相比,肺癌患者血清CEA,CYFRA21-1和NSE水平均明显升高,差异具有统计学意义(χ2=48.208104.889,P<0.01)。联合两项或三项血清标志物的检测能明显提高对肺癌诊断的敏感度,但特异度有所下降。在不同病理类型的肺癌中,血清CEA,CYFRA21-1和NSE水平分别在腺癌、非小细胞肺癌、小细胞肺癌中的阳性率较高。发生转移的肺癌患者中的血清CEA水平高于未转移的肺癌患者(Z=-3.056,P=0.002)。结论 联合检测血清CEA,CYFRA21-1和NSE水平在不同病理类型肺癌诊断及转移中具有一定临床价值。  相似文献   

17.
目的探讨非小细胞肺癌患者肺组织中程序性死亡受体-1、程序性死亡配体-1蛋白表达与表皮生长因子受体基因突变、临床特征及预后的相关性,为临床治疗提供参考.方法将117例非小细胞肺癌患者设为研究组,60例良性病例设为对照组,采用免疫组化法检测两组肺组织中程序性死亡受体-1、程序性死亡配体-1蛋白表达,采用荧光聚合酶链式反应法检测研究组表皮生长因子受体基因突变情况,对研究组不同临床特征患者的表皮生长因子受体基因突变及程序性死亡受体-1、程序性死亡配体-1蛋白表达进行分析.结果研究组肺组织中程序性死亡受体-1、程序性死亡配体-1蛋白阳性表达率(35.0%、54.7%)显著高于对照组(19.0%、15.5%)(P<0.05或0.01);研究组女性、高分化患者表皮生长因子受体基因突变率高,肿瘤分期Ⅲ期、Ⅳ期患者程序性死亡配体-1蛋白表达阳性率高,程序性死亡配体-1蛋白表达与表皮生长因子受体基因突变呈显著正相关,程序性死亡配体-1蛋白表达阳性较阴性患者的无进展生存期显著缩短(P<0.05或0.01).结论非小细胞肺癌患者肺组织中程序性死亡受体-1、程序性死亡配体-1蛋白表达阳性率高,程序性死亡配体-1蛋白表达与表皮生长因子受体基因突变显著相关;对表皮生长因子受体基因突变型非小细胞肺癌患者使用表皮生长因子受体的酪氨酸激酶抑制剂治疗,程序性死亡配体-1蛋白表达阳性患者可能预后较差.  相似文献   

18.
目的 探讨小细胞肺癌(SCLC)、肺鳞癌和肺腺癌患者胃泌素前体释放肽片段31-98(Pro-CLIP)、细胞角蛋白-19(CYFRA21—1)和癌胚抗原(CEA)单项及联合检测对肺癌所致恶性胸腔积液鉴别诊断与组织学分型的临床价值。方法 将103例肺癌所致恶性胸腔积液患者分为SCLC组33例、肺腺癌组37例和肺鳞癌组33例,并以良性胸腔积液组37例及正常对照组35例加以对照。对其血清和胸腔积液ProGRP、CYFRA21-1、CEA进行单项及联合检测,并进行比较。结果 不同肺癌组血清及胸腔积液中ProGRP、CY-FRA21-1、CEA水平均明显高于良性胸腔积液组和正常对照组(P〈0.01);胸腔积液ProGRP单项检测诊断SCLC所致恶性胸腔积液的Youden指数和诊断准确性最高;诊断肺腺癌和肺鳞癌所致恶性胸腔积液的Yon-den指数及诊断准确性均以胸腔积液CEA、CYFRA21—1联合检测(按平行试验)最高。结论 胸腔积液Pro-GRP是SCLC所致恶性胸腔积液的首选肿瘤标志物;胸腔积液CEA与CYFRA21-1联合检测(按平行试验)为肺腺癌和肺鳞癌所致恶性胸腔积液较好的辅助诊断指标。  相似文献   

19.
目的探讨非小细胞肺癌(NSCLC)术后外周血微转移的基因诊断方法,并分析黏蛋白1(MUC1)mRNA、角蛋白19(CK19)mRNA作为肺癌微转移检测分子标志物的可行性。方法应用逆转录聚合酶链反应(RT—PCR),对60例NSCLC病人(肺癌组)的外周血MUC1 mRNA、CK19 mRNA表达情况进行检测;以10例肺良性病变病人及15例健康人的外周血标本作对照。结果肺癌组外周血MUC1 mRNA阳性表达21例(35%),CK19 mRNA阳性表达18例(30%);对照组MUC1 mRNA和CK19 mRNA表达均为阴性,两组比较差异均有显著性(x^2=7.292、5.921,P〈0.01、0.05)。结论MUC1、CK19基因均可作为RT—PCR法检测NSCLC病人淋巴结微转移的分子标志物,两者联合检测可能有助于肺癌转移早期诊断。  相似文献   

20.
目的探讨肺癌患者与空腹血糖(FBG)的关系。方法选择入院前未经治疗、无糖尿病史的肺癌患者560例为研究组,根据细胞学类型分为2个亚组:小细胞肺癌组(70例)及非小细胞肺癌组(490例)。非小细胞肺癌组再根据病理分型分为鳞癌组(156例)、腺癌组(292例)和腺鳞癌组(42例)。另选取同期住院治疗的无糖尿病史的非恶性肿瘤患者500例为对照组。所有患者晨起采集空腹静脉血2 m L,采用葡萄糖氧化酶法进行FBG测定。对各组的FBG进行比较。结果除鳞癌组外,研究组及各亚组患者FBG明显高于对照组(均P〈0.05)。研究组、小细胞癌组、非小细胞肺癌组、腺癌组及腺鳞癌组6.1 mmol·L^-1〈FBG≤7.0mmol·L^-1。发生率高于对照组(P〈0.05);研究组、小细胞肺癌组患者3.9mmol·L^-1≤FBG≤6.1mmol·L^-1发生率低于对照组(P〈0.05)。研究组各亚组患者的FBG比较差异均无统计学意义(均P〉0.05)。结论肺癌患者特别是小细胞癌、腺癌及腺鳞癌患者较容易发生FBG升高.且考虑与肺癌本身有关。  相似文献   

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