支气管动脉灌注治疗对肺癌患者肿瘤标志物的影响及临床疗效分析

目的观察肺癌患者支气管动脉灌注治疗(BAI)前后的外周血癌胚抗原(CEA)、血管内皮生长因子(VEGF)、特异性烯醇化酶(NSE)、细胞角蛋白片段(CYFRA21-1)、鳞状细胞癌抗原(SCC)的变化,评估支气管动脉灌注(BAI)治疗效果和安全性。方法选择40例健康人为对照组。选择已经确诊的80例肺癌患者随机分为两组,分别进行BAI(40例)和全身化疗(40例),治疗前和治疗2个疗程后,用ELISA法检测外周血CEA、VEGF、NSE、CYFRA21-1、SCC;并同时于治疗前后行CT等检查确定病灶大小和判断临床分期,临床疗效按完全缓解(CR)、部分缓解(PR)、稳定(SD)和恶化(PD)进行评定。结果肺癌患者血清CEA、VEGF、NSE、CYFRA21-1、SCC水平,均显著高于对照组,统计学处理差异有统计学意义(P<0.01)。BAI和全身化疗后有效组(CR+PR)肿瘤标志物均较治疗前下降,差异有统计学意义(P<0.01);BAI治疗后肿瘤标志物下降幅度较全身化疗明显,但差异无统计学意义(P>0.05)。而SD和PD组肿瘤标志物下降不明显,差异无显著性。支气管动脉灌注对原发灶的治疗有效率较全身化疗明显增高。结论肺癌患者CEA、VEGF、NSE、CYFRA21-1、SCC明显高于对照组;BAI和全身化疗皆可以降低肺癌患者血清CEA、VEGF、NSE、CY-FRA21-1、SCC水平和抑制肿瘤生长,两种方法对这肿瘤标志物的影响无差异,但BAI能更有效抑制原发灶生长;这肿瘤标志物联检可以提高肺癌的诊断准确率。

Effect and Clinical Analysis of Bronchial Artery Infusion Therapy on Tumor Markers in Patients with Lung Cancer

Objective To investigate the changes of serum eareineombryonic antigen （ CEA）, Vascular endothelial growth factor （ VEGF）, Neuron specific enolase （ NSE ） , Cytokeratin 19 fragment （ CYFRA21- 1 ） , Squamous cell carcinoma antigen （ SCC ） before and after the BAI in patients with lung cancer and evaluate the effect and salty of BAI. Methods 40 healthy eases were set as control group. 80 cases with definite diagnosis of lung cancer were divided into two groups,each having 40 eases had therapy of BAI and systemic ehemotherapy respectively. EIISA was used to detect the serum CEA, VEGF, NSE, CYFRA21-1 and SCC before and after therapy about 2 courses of treatment. At the mean time, CT was used to detect the size of focus and judge clinical stage. Clinical effect was evaluated aeeording to CR, PR, SD and PD. Results Serum CEA,VEGF,NSE,CYFRA21-1 and SCC in lung cancer were all higher that that of control group. There is statistic significance （P 〈 0.01 ）. Tumor markers of CR and PR groups with BAI and systemie chemotherapy were all decreased than that before therapy, there was also great statistic significance（ P 〈 0.01 ）. Tumor markers in the group with BAI was decreased more than that of group with systemic chemotherapy,but there was no great significance between them. （ P 〉 0.05 ）. SD and PD group had no obviousely deereasing and there was no great significance between them. BAI had higher effective power on primary tumor than systemic ebemotherapy. Conclusion Serum CEA,VEGF,NSE,CYFRA21-1 AND SCC in group with lung eaneer is higher than that of control group. BAI and systemic chemotherapy can decrease the serum level of CEA, VEGF, NSE, CYFRA21-1 AND SCC,and inhibit the tumor growth. There is no difference influence found on tumor markers between two methods, but BAI can inhibit the primary tumor growth more bigger. Tumor markers combined deteetion can promote the diagnositie accuracy of lung cancer.