摘要
目的 探讨新辅助化疗联合阴式广泛子宫切除术对Ⅱa期局部肿块型宫颈癌的治疗效果.方法 根据治疗方式的不同将97例Ⅱa期局部肿块型宫颈癌患者分为观察组(n=47)和对照组(n=50),对照组患者接受阴式广泛子宫切除术治疗,观察组患者接受新辅助化疗联合阴式广泛子宫切除术治疗.评估观察组患者的临床疗效,比较两组患者肿瘤标志物[癌胚抗原(CEA)、鳞状细胞癌抗原(SCC-Ag)、糖类抗原15-3(CA15-3)]水平、T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)水平、生活质量[世界卫生组织生活质量测定量表简表(WHOQOL-BREF)]及不良反应发生情况.结果 观察组患者的总有效率为78.72％.手术后,两组患者CEA、SCC-Ag、CA15-3水平均低于本组治疗前,观察组患者CEA、SCC-Ag、CA15-3水平均低于对照组,差异均有统计学意义(P＜0.05).手术后,观察组患者CD3+、CD4+水平和CD4+/CD8+均高于对照组,CD8+水平低于对照组,差异均有统计学意义(P＜0.05).手术后,两组患者生理、心理、环境、社会关系评分均高于本组治疗前,观察组患者生理、心理、环境、社会关系评分均高于对照组,差异均有统计学意义(P＜0.05).两组患者恶心呕吐、脱发、骨髓抑制、肝肾功能减退发生率比较,差异均无统计学意义(P＞0.05).结论 新辅助化疗联合阴式广泛子宫切除术对Ⅱa期局部肿块型宫颈癌的治疗效果较好,可降低肿瘤标志物水平,改善免疫功能,提高生活质量,且不良反应发生率较低.
Abstract
Objective To analyze the clinical efficacy of neoadjuvant chemotherapy combined with vaginal extensive hysterectomy on stage Ⅱa local mass cervical cancer.Method A total of 97 patients with stage Ⅱa local mass cervical cancer were selected,according to different treatment methods,they were divided into observation group(n=47)and con-trol group(n=50).The control group received vaginal extensive hysterectomy,while the observation group received neo-adjuvant chemotherapy combined with vaginal extensive hysterectomy.The clinical efficacy of observation group was evaluated,and the tumor marker[carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC-Ag),carbohy-drate antigen 15-3(CA15-3)]levels,T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)levels,quality of life[World Health Organization quality of life assessment instrument brief version(WHOQOL-BREF)],and incidence of adverse re-actions were compared between the two groups.Result The total effective rate of observation group was 78.72％.After surgery,the levels of CEA,SCC-Ag,and CA15-3 in both groups were lower than those before the treatment,the levels of CEA,SCC-Ag,and CA15-3 in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).After surgery,the levels of CD3+,CD4+,and CD4+/CD8+in the observation group were higher than those in the control group,while the level of CD8+was lower than that in the control group,and the differenc-es were statistically significant(P＜0.05).After surgery,the physiological,psychological,environmental,and social rela-tionship scores of the two groups were higher than those before the treatment,the physiological,psychological,environ-mental,and social relationship scores of the observation group were higher than those of the control group,and the differ-ences were statistically significant(P＜0.05).There were no statistically significant differences in the incidence of nausea,vomiting,hair loss,bone marrow suppression,and liver and kidney dysfunction between the two groups(P＞0.05).Conclusion Neoadjuvant chemotherapy combined with vaginal extensive hysterectomy is effective in the treatment of stage Ⅱa local mass cervical cancer,which can reduce tumor marker levels,improve immune function,and improve quali-ty of life,with low incidence of adverse reactions.
维普
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