食管通结方对食管癌新辅助化疗患者血清CEA、CYFRA21-1和疗效的影响
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摘要
目的观察食管通结方对食管癌新辅助化疗患者血清CEA、CYFRA21-1及化疗疗效的影响。方法将68例食管癌中下段伴纵膈和腹腔淋巴结转移的患者,随机分为对照组和治疗组各34例,对照组给予紫杉醇加卡铂方案(紫杉醇175 mg/m2、卡铂AUC=5)化疗2个疗程,治疗组在化疗的基础上加用食管通结方(党参、天龙、急性子、石见穿、制南星、煨诃子、枸橘李)服用2个月。结果治疗后两组血清CEA、CYFRA21-1水平均较治疗前有所下降,治疗组下降更加明显,差异有统计学意义(P <0.05)。并且治疗后,治疗组血清CEA水平和对照组相比明显降低,有统计学意义(P <0.05),血清CYFRA21-1 2组相比下降无统计学差异。治疗组总有效率为76.7%,明显高于对照组41.1%,差异有统计学意义(P <0.05)。结论食管通结方能降低患者化疗后血CEA、CYFRA21-1的水平,提高化疗的治疗效果,在一定程度上起到减瘤增效的作用。
Objective To observe the influence of Shiguan Tongjie decoction on the efficacy and the serum levels of CEA and CYFRA21-1 in patients with esophagus cancer after neoadjuvant chemotherapy. Methods 68 patients with lower esophagus cancer with mediastinum and abdominal lymph node metastasis were randomly divided into control and treatment group, 34 patients in each group. The control group was treated with 2 courses of chemotherapy of paclitaxel plus carboplatin(paclitaxel 175 mg/m2, carboplatin AUC = 5), the treatment group was additionally treated with Shiguan Tongjie decoction for two months. Results After treatment, the levels of serum CEA and CYFRA21-1 in both groups decreased compared with that before treatment, the treatment group was more obvious with significant diff erence(P < 0.05). After treatment, the serum CEA level in the treatment group was significantly lower than that in the control group(P < 0.05), but the lower of serum CYFRA21-1 level shows nostatistical significant diff erence between the two groups. The total eff ective rate of the treatment group was 76.7%, which is significantly higher than that in the control group(41.1%), the diff erence was statistically significant(P < 0.05). Conclusion Shiguan Tongjiedecoction can reduce levels of serum CEA and CYFRY21-1 in patients after neoadjuvant chemotherapy, improve the therapeutic eff ect of chemotherapy. To a certain extent, it can help fight tumor and improve efficacay.
Objective To observe the influence of Shiguan Tongjie decoction on the efficacy and the serum levels of CEA and CYFRA21-1 in patients with esophagus cancer after neoadjuvant chemotherapy. Methods 68 patients with lower esophagus cancer with mediastinum and abdominal lymph node metastasis were randomly divided into control and treatment group, 34 patients in each group. The control group was treated with 2 courses of chemotherapy of paclitaxel plus carboplatin(paclitaxel 175 mg/m2, carboplatin AUC = 5), the treatment group was additionally treated with Shiguan Tongjie decoction for two months. Results After treatment, the levels of serum CEA and CYFRA21-1 in both groups decreased compared with that before treatment, the treatment group was more obvious with significant diff erence(P < 0.05). After treatment, the serum CEA level in the treatment group was significantly lower than that in the control group(P < 0.05), but the lower of serum CYFRA21-1 level shows nostatistical significant diff erence between the two groups. The total eff ective rate of the treatment group was 76.7%, which is significantly higher than that in the control group(41.1%), the diff erence was statistically significant(P < 0.05). Conclusion Shiguan Tongjiedecoction can reduce levels of serum CEA and CYFRY21-1 in patients after neoadjuvant chemotherapy, improve the therapeutic eff ect of chemotherapy. To a certain extent, it can help fight tumor and improve efficacay.
引文
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[16]杜兰宁,邰霄辉,王丽娜,等.食管癌患者放疗前后血清癌胚抗原和细胞角蛋白19片段水平变化及临床意义[J].兰州大学学报(医学版),2014,40(2):63-65.
[17]崔清,董昀,张铭,等.食道通结方对裸鼠食管癌移植瘤中te-1细胞增值及凋亡的影响[J].上海中医药杂志,2016,50(5):65-69.
[18]张铭,李蕾,崔清,等.食道通结方对食管癌细胞株TE-1增值和凋亡的影响[J].上海中医药杂志,2014,48(6):92-95.
[19]金长娟,李蕾,崔清,等.食管癌术后中西医综合治疗临床观察[J].肿瘤,2003,23(5):429-431.
[20]崔清,张铭,董昀,等.食道通结方联合化疗治疗中晚期食管癌术后患者临床疗效观察[J].上海中医药杂志,2015,49(6):29-32.
[2]陈万青,郑荣寿,张思维,等.2012年中国恶性肿瘤发病和死亡分析[J].中国肿瘤,2016,25(1):1-8.
[3]陈龙奇.制订2009第7版食管癌TNM分期标准[J].中国胸心血管外科临床杂志,2008,15(1):52-55.
[4]上海市卫生局.上海市中医病证诊疗常规[M].2版.上海:上海中医药大学出版社,2002:20-21.
[5]CHUNG CS,LEE YC,WU MS.Prevention strategies for esophageal cancer:perspectives of the East vs West[J].Best Pract Res Clin Gastroenterol,2015,29(6):869-883.
[6]RUSTGI AK,EL-SERAG HB.Esophageal carcinoma[J].NEngl J Med,2014,371(26):2499-2509.
[7]EISENHAUER P,THERASSE J,BOGAERTS L H,et al.New response evaluation criteria in solid tumours:Revised RECISTguideline(version 1.1)[J].E.A.European Journal of Cancer,2009 Jan,45(2):228-47.
[8]古福志,朱卫国,张泉,等.淋巴结阳性食管癌术后单纯放疗与同步放化疗的临床对照研究[J].中国临床研究,2015,28(11):1429-1432.
[9]孟春芹,丁芋友,唐凌,等.食管癌的中西医治疗[J].长春中医药大学学报,2013,29(5):835-837.
[10]陈云.贞芪扶正颗粒对食管癌化疗患者生存质量及免疫功能的影响[J].吉林中医药,2015,35(10):1025-1027.
[11]王洪鹏,李晓君.食管癌的中西医治疗进展研究[J].吉林中医药,2013,33(4):428-429.
[12]Prithviraj GK,Baksh K,Fulp W,et al.Carboplation and paclitaxel as fi rst-line treatment of unresectable or metastatic esophageal or gastric cancer[J].Dis Esophagus,2015,28(8):782-787.
[13]任传利,韩崇旭,王大新,等.血清CA19-9、CEA、CA125联合检测诊断食管癌的价值[J].山东医药,2010,50(47):24-25.
[14]YAN H J,WANG R B,ZHU K L,et al.Cytokeratin 19fragment antigen 21-1 as an independent predictor for definitive chemoradiotherapy sensitivity in esophageal squamous cell carcinoma[J].Chin Med J(Engl),2012,125(8):1410-1415.
[15]CARPELAN H M,LOUHIMO J,STENMAN U H,et al.CEA,CA19-9andCA72-4 improve the diagnostic accuracy in gastrointestinal cancers[J].Anticancer Res,2002,22(4):2311-2316.
[16]杜兰宁,邰霄辉,王丽娜,等.食管癌患者放疗前后血清癌胚抗原和细胞角蛋白19片段水平变化及临床意义[J].兰州大学学报(医学版),2014,40(2):63-65.
[17]崔清,董昀,张铭,等.食道通结方对裸鼠食管癌移植瘤中te-1细胞增值及凋亡的影响[J].上海中医药杂志,2016,50(5):65-69.
[18]张铭,李蕾,崔清,等.食道通结方对食管癌细胞株TE-1增值和凋亡的影响[J].上海中医药杂志,2014,48(6):92-95.
[19]金长娟,李蕾,崔清,等.食管癌术后中西医综合治疗临床观察[J].肿瘤,2003,23(5):429-431.
[20]崔清,张铭,董昀,等.食道通结方联合化疗治疗中晚期食管癌术后患者临床疗效观察[J].上海中医药杂志,2015,49(6):29-32.