培美曲塞联合顺铂对晚期非鳞非小细胞肺癌患者血清肿瘤标志物的影响

目的 探讨培美曲塞联合顺铂治疗晚期非鳞非小细胞肺癌对血清肿瘤标志物的影响。方法 采用随机抽样、随访、回顾性调查研究方法，2013年6月—2015年8月选择在重庆市开州区人民医院进行诊治的晚期非鳞非小细胞肺癌患者102例作为研究对象，根据治疗方法的不同分为观察组与对照组各51例。对照组给予紫杉醇联合顺铂的常规化疗；观察组给予培美曲塞联合顺铂治疗，21 d为1个治疗周期，两组都治疗观察4个周期。比较两组临床疗效和毒副反应情况，采用酶联免疫吸附（ELISA）法测定癌胚抗原（CEA）、载脂蛋白A1（ApoA1）表达情况，随访并比较两组的生存期。结果 治疗后观察组与对照组的总有效率分别为76.5%和41.2%，观察组高于对照组，差异有统计学意义（P<0.05）。治疗期间观察组的皮肤反应、骨髓抑制、消化道反应等毒副反应情况与对照组相比无统计学意义。观察组与对照组治疗后的CEA值都低于治疗前，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后观察组的CEA低于对照组，差异有统计学意义（P<0.05）。观察组与对照组治疗后的ApoA1值都高于治疗前，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后观察组的ApoA1高于对照组，差异有统计学意义（P<0.05）。观察组与对照组的中位生存期分别为（16.44±2.12）个月和（11.94±3.19）个月，KM法分析显示观察组高于对照组，差异有统计学意义（P<0.05）。结论 培美曲塞联合顺铂治疗晚期非鳞非小细胞肺癌应用能降低血清肿瘤标志物CEA表达水平，提高ApoA1表达水平，提高治疗疗效，且不会增加毒副反应的发生，从而延长患者的生存期。

Effects of pemetrexed combined with cisplatin on serum tumor markers in patients with advanced non squamous non-small cell lung cancer

Objective To investigate the effects of pemetrexed combined with cisplatin on serum tumor markers in patients with advanced non squamous non-small cell lung cancer.Methods Used the random sampling, follow-up and retrospective study method, From June 2013 to August 2015,102 patients with advanced non squamous non-small cell lung cancer in our hospital for diagnosis and treatment were divided into observation group and control group of 51 patients in each groups accorded to the different treatment methods. The control group given paclitaxel plus cisplatin standard chemotherapy. Observation group was given pemetrexed combined cisplatin treatment, 21 d was 1 treatment cycles, and the two groups were treated for 4 cycles.Results After treatment, the total effective rates in the observation group and the control group were 60.8% and 41.2%, respectively, and the observation group was higher than that of the control group (P<0.05). During the treatment, the adverse reactions such as skin reaction, bone marrow suppression and digestive tract reaction in the observation group were not significantly different from those in the control group. Observation group and control group after treatment serum CEA values are lower than before treatment, after treatment the CEA group than controls (P<0.05), the observation group and control group after treatment of ApoA1 values are higher than that of before treatment, after treatment group ApoA1 is higher than the control group (P<0.05).The median survival times in the observation group and the control group were (16.44 ±2.12) months and (11.94 ±3.19) months, respectively. The KM analysis showed that the observation group was higher than that of the control group (t=5.388, P<0.05).Conclusion Pemetrexed combined with cisplatin treatment of advanced application scale non-small cell lung cancer can lower serum tumor markers CEA expression level and improve the level of expression of ApoA1, improve curative effect, and do not increase the occurrence of adverse reaction, so as to prolong patient survival.