多西他赛+卡铂联合宫颈癌根治术治疗宫颈癌疗效及对血清肿瘤标志物和细胞免疫因子的影响
Effect of docetaxel and carboplatin combined with radical cervical cancer in the treatment of cervical cancer and the influence of serum tumor markers and cytokines
刘添娣 1李清 1季伟1
作者信息
- 1. 西北妇女儿童医院妇科,西安 710061
- 折叠
摘要
目的 探讨多西他赛+卡铂联合宫颈癌根治术对宫颈癌患者血清肿瘤标志物、Th1/Th2型细胞因子表达水平的影响.方法 选择西北妇女儿童医院2018年8月至2020年8月间96例确诊为宫颈癌的患者作为研究对象,按照随机数字表法随机分为手术组和化疗+手术组.手术组直接进行宫颈癌根治术(腹腔镜广泛子宫切除术+盆腔淋巴结清扫术),化疗+手术组于术前进行多西他赛+卡铂辅助化疗,比较两组血清肿瘤标志物[癌胚抗原(carcino-embryonic antigen,CEA)、糖类抗原 125(carbohydrate antigen 125,CA125)、糖链抗原 19-9(carbohydrate antigen 19-9,CA19-9)、鳞状上皮细胞癌抗原(squamous cell carcinoma antigen,SCC)]、Th1/Th2型细胞因子[γ干扰素(interferon-γ,IFN-γ)、白介素-2(interleukin-2,IL-2)、IL-4、IL-6]表达及骨髓抑制发生情况,并评价近期疗效.结果 治疗前两组血清CEA、CA125、CA19-9、SCC差异无统计学意义(P＞0.05),治疗后均有明显降低(P＜0.05),其中化疗+手术组显著低于手术组(P＜0.05).治疗后手术组和化疗+手术组IFN-γ分别为20.58±3.52和25.69±3.61,相比治疗前的11.75±2.59和12.15±2.65明显提高;治疗后两组的IL-2分别为24.68±4.46和29.53±5.28,相比治疗前的17.26±3.96 和17.52±4.23明显提高;治疗后两组的IL-4分别为17.65±4.12和13.59±4.23,相比于治疗前的22.56±4.74和23.13±4.86明显降低;治疗后两组的IL-6分别为24.59±3.85和31.76±4.42,相比于治疗前的41.78±4.71和42.35±5.59明显降低;治疗后两组血清CEA分别为(33.89±5.51)ng/L和(30.46±4.86)ng/L,相比于治疗前的(44.34±5.62)ng/L和(44.71±5.75)ng/L,均明显降低;治疗后两组CA125 分别为(51.96±5.85)μg/L 和(47.23±5.46)μg/L,相比于治疗前的(64.81±6.7 1)μg/L 和(65.43±6.62)μg/L均明显降低;治疗后两组CA19-9分别为(42.21±5.23)U/mL和(37.56±5.61)U/mL,相比于治疗前的(51.46±5.71)和(52.13±6.20)U/mL均明显降低;治疗后两组SCC分别为(1.12±0.12)μg/mL和(0.96±0.15)μg/mL,相比于治疗前的(1.22±0.17)μg/mL和(1.24±0.18)μg/mL均明显降低.化疗+手术组治疗有效率显著高于手术组(P＜0.05),两组骨髓抑制情况差异无统计学意义(P＞0.05).结论 宫颈癌根治术前行多西他赛+卡铂辅助化疗能显著提高临床治疗效果,降低血清肿瘤标志物水平,提高机体免疫功能,且不会增加不良反应,值得推广.
Abstract
Objective To investigate the effects of docetaxel,Carboplatin combined with radical cervical cancer surgery on the expression of serum tumor markers and Th1/Th2 cytokines in patients with cervical cancer.Methods 96 patients with cervical cancer from Aug.2018 to Aug.2020 were selected as the study subjects.They were randomly divided into operation group and chemotherapy+operation group according to random number table method.Surgical group underwent radical hysterectomy(laparoscopic hysterectomy+pelvic lymph node dissec-tion),chemotherapy+surgery group received docetaxel+Carboplatin adjuvant chemotherapy before operation.Se-rum tumor markers[CEA,CA125,CA19-9,squamous epithelium fine]were compared between the two groups.The expression of SCC,Th1/Th 2 cytokines[IFN-gamma,IL-2,IL-4,IL-6]and the occurrence of bone marrow suppres-sion were evaluated.Results There was no significant difference in serum CEA,CA125,CA19-9 or SCC between the two groups before treatment(P＞0.05),but they were significantly decreased after treatment(P＜0.05).After treatment,IFN-γ[(20.58±3.52);(25.69±3.61)]and IL-2[(24.68±4.46);(29.53±5.28)]were significantly in-creased in the two groups(P＜0.05).IL-4[(17.65±4.12);(13.59±4.23)]and IL-6[(24.59±3.85)(31.76±4.42)]were significantly decreased(P＜0.05).IFN-γ and IL-2 in the acupuncture group were significantly higher than those in the operation group(P＜0.05).IL-4 and IL-6 were significantly lower than those in the operation group(P＜0.05),and serum CEA[(33.89±5.51)ng/L;(30.46±4.86)ng/L],CA125,CA19-9[(42.21±5.23)U/mL;(37.56±5.61)U/mL]and SCC[(1.12±0.12)μg/mL;(0.96±0.15)μg/mL]were significantly decreased(P＜0.05).The che-motherapy group was significantly lower than the surgery group(P＜0.05),and the effective rate of chemotherapy group was significantly higher than that of the operation group(P＜0.05),and there was no significant difference in myelosuppression between the two groups(P＞0.05).Conclusion Docetaxel plus Carboplatin adjuvant chemo-therapy before radical operation of cervical cancer can significantly improve the clinical efficacy,reduce the level of serum tumor markers,improve immune function,and do not increase adverse reactions.It is worth promoting.
关键词
多西他赛/卡铂/宫颈癌/化疗/肿瘤标志物/免疫功能Key words
Docetaxel/Carboplatin/Cervical cancer/Chemotherapy/Tumor markers/Immune function引用本文复制引用
基金项目
陕西省重点研发计划项目(2019SF-137)
出版年
2024
NETL
NSTL
万方数据