CT引导下125I放射性粒子组织间植入联合化疗治疗NSCLC临床疗效及患者CEA和CYFRA21-1的动态水平观察

摘要

目的 观察125I放射性粒子组织间植入联合化疗治疗非小细胞肺癌(NSCLC)的临床疗效及患者血清癌胚抗原(CEA)、细胞角质素片段抗原(CYFRA21-1)水平的动态变化.方法 将2014年1月至2016年6月期间我院收治的92例NSCLC患者作为研究对象,随机分为两组,各46例;研究组予以CT引导下125I放射性粒子植入联合药物化疗,对照组予以药物化疗,比较两组患者的治疗效果和治疗前后血清CEA、CY-FRA21-1水平,并分析CEA、CYFRA21-1水平变化对治疗效果的影响.结果 治疗后6个月和12个月时,研究组患者的治疗有效率均明显高于对照组(P<0.05);治疗后12个月,研究组患者的血清CEA、CYFRA21-1水平明显低于对照组(P<0.05);治疗后CEA降低组患者的治疗有效率和生存率均明显高于CEA增高组(P<0.01),CYFRA21-1降低组的治疗有效率和生存率亦显著高于CYFRA21-1增高组(P<0.01).结论 CT引导下125I放射性粒子组织间植入联合化疗治疗NSCLC具有可靠的近期疗效,并可显著降低患者的血清CEA和CYFRA21-1水平,而CEA和CYFRA21-1水平的动态变化对患者的预后具有提示作用.%Objective To observe the clinical effect of 125I radioactive seeds implantation combined with chemotherapy in the treatment of NSCLC and dynamic changes of CEA and CYFRA21-1levels. Methods 92 NSCLC patients in our hospital from January 2014 to June 2016 were selected as the research objects. According to the treat-ment methods,they were divided into two groups,42 cases in each group. The research group was given 125I seeds implantation guided by CT,and the control group was given paclitaxel and cisplatin drug therapy. The clinical effect of the two groups were compared and serum CEA,CYFRA21-1 level changes were analyzed. Results 6 months and 12 months after treatment,the treatment effective rate of the research group was significantly higher than that of the control group (P<0.05). 12 months after treatment, the levels of serum CEA and CYFRA21-1 were significantly lower in the research group than in the control group(P<0.05). The treatment effective rate and survival rate of pa-tients with lower CEA level after treatment were significantly higher than those with higher CEA level after treatment (P<0.01),and the treatment effective rate and survival rate of patients with lower CYFRA21-1 level after treatment were significantly higher than those with higher CYFRA21-1 level after treatment (P <0.01). Conclusion 125 I seeds implantation guided by CT combined with chemotherapy has the reliable short-term curative effect in treatment of NSCLC,and it can significantly reduce the levels of serum CEA and CYFRA21-1, and the dynamic changes of CEA and CYFRA21-1 levels have implications for the prognosis of patients.