摘要
目的 研究支气管镜下冷冻疗法配合全身化疗用于晚期肺癌的疗效及对患者血清肿瘤标志物、T淋巴细胞亚群指标的影响.方法 选择100 例晚期肺癌患者,按不同化疗方法分为2 组,各50 例.对照组实施全身化疗,观察组实施支气管镜下冷冻疗法配合全身化疗.比较 2 组临床疗效、肿瘤标志物[癌胚抗原(CEA)、神经元特异性烯醇酶(NSE)、细胞角质素片断抗原(CYFRA21-1)、糖链抗原19-9(CA199)]、T细胞亚群[CD4+、CD8+、CD4+/CD8+]、生活质量及不良反应.结果 观察组治疗总有效率为94.00%(48/50),与对照组的80.00%(40/50)对比,有统计学差异(P<0.05).治疗后,观察组CEA水平为(25.36±3.81)ng/ml、NSE水平为(28.14±4.03)ng/ml、CYFRA21-1 水平为(12.81±1.04)ng/ml、CA199 水平为(31.57±3.68)ng/ml,低于对照组的(53.24±6.78)ng/ml、(55.89±8.54)ng/ml、(19.97±1.81)ng/ml、(50.12±4.60)ng/ml;CD4+水平为(0.52±0.07)、CD4+/CD8+水平为(1.67±0.21),高于对照组(0.41±0.05)、(1.41±0.14);CD8+水平为(0.22±0.04),低于对照组的(0.30±0.08).癌症治疗功能评价系统(FACT)中的生理状况评分为(19.89±6.57)分、社会状况评分为(19.91±6.24)分、情感状况评分为(13.98±7.04)分、功能状况评分为(15.31±5.40)分,高于对照组的(17.42±5.61)分、(16.68±5.91)分、(12.23±5.60)分、(12.69±5.44)分,有统计学差异(P<0.05).2 组不良反应比较,无统计学差异(P>0.05).结论 支气管镜下冷冻疗法配合全身化疗治疗晚期肺癌效果确切,可有效提高临床疗效及患者生活质量,降低患者血清肿瘤标志物水平,安全可靠.
Abstract
Objective To investigate the effects of bronchoscopic cryotherapy combined with systemic chemotherapy on serum tumor markers and T lymphocyte subsets in patients with advanced lung cancer.Methods 100 patients with advanced lung cancer were selected and divided into 2 groups according to different chemotherapy methods,with 50 patients in each group.The control group received systemic chemotherapy,while the observation group received bronchoscopic cryotherapy combined with systemic chemotherapy.The clinical efficacy,tumor markers[Carcinoembryonic antigen(CEA),neuron specific enolase(NSE),cytokeratin fragment antigen(CYFRA21-1),carbohydrate antigen 19-9(CA199)],T cell subsets[CD4+,CD8+,CD4+/CD8+],quality of life and adverse reactions were compared between the 2 groups.Results The total effective rate of the obser-vation group was 94.00%(48/50),which was statistically different from the 80.00%(40/50)of the control group(P<0.05);After treatment,the CEA levels in the observation group were(25.36±3.81)ng/ml,NSE levels were(28.14±4.03)ng/ml,CYFRA21-1 levels were(12.81±1.04)ng/ml,and CA199 levels were(31.57±3.68)ng/ml,which were lower than the control group's(53.24±6.78)ng/ml,(55.89±8.54)ng/ml,(19.97±1.81)ng/ml,and(50.12±4.60)ng/ml;The CD4+level was(0.52±0.07),and the CD4+/CD8+level was(1.67±0.21),which was higher than the control group(0.41±0.05)and(1.41±0.14);The CD8+level was(0.22±0.04),lower than the control group's(0.30±0.08);The physiological status score,social status score,emotional status score,and functional status score in the Cancer Treatment Function Evaluation System(FACT)were(19.89±6.57),(19.91±6.24),(13.98±7.04),and(15.31±5.40),which were higher than the control group's(17.42±5.61),(16.68±5.91),(12.23±5.60),and(12.69±5.44)scores,with a statistical difference(P<0.05);There was no sta-tistically significant difference in adverse reactions between the 2 groups(P>0.05).Conclusion Bronchoscopic cryotherapy combined with systemic chemotherapy is effective in treating advanced lung cancer patients,effectively improving clinical efficacy and quality of life,reducing serum tumor indicators levels,and being safe and reliable.
维普
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