顺铂、紫杉醇联合治疗中晚期宫颈癌的疗效及对患者CYFRA21-1、SCC-Ag和预后的影响

目的 探讨紫杉醇联合顺铂治疗中晚期宫颈癌的疗效及对患者鳞状上皮癌抗原（SCC-Ag）、细胞角蛋白19片段抗原21-1（CYFRA21-1）水平的影响。方法 选取惠州市惠东县妇幼保健院实施化疗的中晚期宫颈癌患者120例，研究对象收集时间2013年1月—2015年7月，根据化疗方案分为A组（紫杉醇联合顺铂治疗）60例、B组（丝裂霉素+顺铂+5-FU治疗）60例，两组患者均经行3～5个疗程的治疗。对比两组患者临床疗效及化疗前、化疗结束后2周患者血清CYFRA21-1、SCCAg的水平，并比较两组预后情况。结果 A组患者的缓解率为84.21%，B组为67.86%，A组显著高于B组（P<0.05）；A组患者的总有效率96.49%与B组患者的92.86%比较差异不具有统计学意义。治疗前，A组和B组患者的血清CYFRA21-1、SCC-Ag水平差异无统计学意义；治疗后，两组患者的血清CYFRA21-1、SCC-Ag水平较本组治疗前均显著的降低（P<0.05）；且A组血清CYFRA21-1、SCC-Ag水平低于B组（P<0.05）。术后1、2、3年生存率比较，两组差异均无统计学意义。A组患者的中位生存时间29.0个月显著的长于B组患者的22.0个月，差异具有统计学意义（P<0.05）。结论 紫杉醇联合顺铂治疗中晚期宫颈癌的近期疗效优于丝裂霉素+顺铂+5-FU，但是对患者远期生存率的提高并不显著。

Efficacy of cisplatin and paclitaxel in treatment of advanced cervical cancer and its effects on CYFRA21-1, SCC-Ag and prognosis

Objective To investigate the effect of paclitaxel and cisplatin in the treatment of advanced cervical cancer and its effect on squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) level.Methods 120 patients with advanced cervical cancer chemotherapy in Huizhou Huidong County Maternal and Child Health Hospitall were selected, the study collected in January 2013 to July 2015, according to the chemotherapy were divided into A group (paclitaxel combined with cisplatin in the treatment of 60 cases (group B), mitomycin and cisplatin + 5-FU therapy) 60 cases, treatment group two patients were treated for 3-5 courses.Results Remission in A group were significantly higher than the rate of 84.21% of the 67.86% patients in the B group (P<0.05). A group of patients with total efficiency of 96.49% and 92.86% patients in the B group compared the difference was not statistically significant. Before treatment, the differences of serum CYFRA21-1, SCC-Ag levels in A group and B group were not statistically significant. After treatment, the patients in the A group serum CYFRA21-1, SCC-Ag levels were significantly lower than in group B (P<0.05), serum CYFRA21-1 and SCC-Ag levels in both groups were significantly reduced than before treatment (P<0.05). Survival rate after 1 years, 2 years, 3 years in A group and B group, there were no significant differences. The median survival time in the A group was 29 months, significantly longer than the 22 months in the B group, and the difference was statistically significant (Log, Rank (Mantel-Cox),=5.220, P=0.022 < 0.05). Conclusion The short-term efficacy of paclitaxel combined with cisplatin in the treatment of advanced cervical cancer is better than that of mitomycin C + cisplatin +5-FU, but the long-term survival rate of the patients is not significant.