摘要
目的探讨保乳手术联合放疗对乳腺癌患者血清肿瘤标志物水平及预后的影响。方法回顾性分析98例乳腺癌患者的病历资料,根据治疗方法不同将患者分为研究组和对照组,其中研究组40例患者采用保乳手术治疗,并于术后2~6周后行放射治疗;对照组58例患者采用乳腺癌根治术治疗。比较两组患者治疗前后血清β2-微球蛋白(β2-MG)、癌胚抗原(CEA)、糖类抗原15-3(CA15-3)、糖类抗原125(CA125)、几丁质酶-3样蛋白-1(YKL-40)的水平,并对两组患者的5年生存情况进行比较。结果治疗前,两组患者的血清β2-MG、CEA、CA15-3、CA125、YKL-40水平比较,差异均无统计学意义(P﹤0.05)。治疗后,研究组患者的血清β2-MG、CEA、CA15-3、CA125、YKL-40水平均明显低于对照组(P﹤0.01);治疗后,研究组患者的血清β2-MG、CEA、CA15-3、CA125、YKL-40水平均低于本组治疗前(P﹤0.05)。研究组患者行放疗过程中,放射性皮肤损伤、放射性食管炎、放射性肺炎的发生率较高,分别为100%、30.00%、25.00%;两组患者的远处转移率、局部复发率、5年生存率比较,差异均无统计学意义(P﹥0.05)。结论乳腺癌患者实施保乳手术联合放疗能够降低患者的血清肿瘤标志物水平,达到与乳腺癌根治术相同的治疗效果,但是放疗引起的不良反应应该予以重视。
Objective To investigate the effect of breast-conserving surgery combined with radiotherapy on the levels of serum tumor markers and prognosis in patients with breast cancer. Method The medical records of 98 patients with breast cancer were retrospectively analyzed. Patients were stratified as study group and control group according to the different treatment methods. 40 patients in the study group were treated with breast-conserving surgery, and radiation therapy was performed 2 to 6 weeks after surgery. In addition, 58 patients in the control group were administered with radical mastectomy. The levels of serum β2-microglobulin(β2-MG), carcinoembryonic antigen(CEA), carbohydrate antigen 15-3(CA15-3), carbohydrate antigen 125(CA125), and chitinase-3-like-1 protein(YKL-40) were compared before and after treatment in the two group, and the 5-year survival of the two groups was evaluated. Result Before treatment, the serum levels of serum β2-MG, CEA, CA15-3, CA125 and YKL-40 in the two groups were not significantly different(P<0.05).After treatment, the serum levels of β2-MG, CEA, CA15-3, CA125 and YKL-40 in the study group were significantly lower than those in the control group(P<0.01). After treatment, the serum levels of β2-MG, CEA, CA15-3, CA125 and YKL-40 in the study group were lower than those before treatment(P<0.05). During the radiotherapy of the study group,the incidence rate of radiation injury of skin, radiation esophagitis and radiation pneumonitis were higher(100%, 30.00%and 25.00%, respectively). The distant metastasis rate, local recurrence rate, and the 5-year survival rate were similar between the two groups(P>0.05). Conclusion Breast-conserving surgery combined with radiotherapy can reduce the serum level of tumor markers in patients with breast cancer, and achieving the same effect as radical mastectomy. However,the adverse reaction caused by radiotherapy should be addressed.
引文
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