微波消融序贯131 I-chTNT放射免疫治疗肺癌对血清肿瘤标志物的影响

摘要

目的：研究应用微波消融序贯131 I-chTNT放射免疫治疗中晚期非小细胞肺癌患者，测定治疗前后患者血清癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白Ig片段(CYFRA21-1)等肿瘤标志物水平，通过对比其变化观察微波消融联合131 I-chTNT放射免疫综合治疗非小细胞肺癌的疗效与肿瘤标志物水平的关系。方法选取中晚期非小细胞肺癌患者78例随机分组，对照组患者(37例)采用多西他赛联合顺铂治疗，观察组患者(41例)采用微波消融序贯131 I-chT-NT放射免疫治疗。观察两组患者的治疗情况，分别于治疗前及治疗后1、3、6个月定血清肿瘤标志物CEA、CA125、CY-FRA21-1水平。结果治疗后观察组患者的总有效率为56．10%，明显高于对照组的48．65%，差异有统计学意义( P<0.05)；治疗后两组患者的血清肿瘤标志物CEA、CA125、CYFRA21-1均较治疗前明显改善，且观察组患者改善更为明显，组间差异有统计学意义(P<0.05)。结论微波消融联合131 I-chTNT放射免疫综合治疗中晚期非小细胞肺癌近期疗效满意，能够有效的降低多项肿瘤标志物的水平。%Objective To study the application of microwave ablation combined with 131 I-chTNT radioimmunotherapy in treating metaphase and advanced phase non-small cell lung cancer patients. Levels of serum tumor markers such as carcinoembry-onic Antigen(CEA), carbohydrate antigen 125(CA125)and Ig fragment of the cell keratin(CYFRA21-1)were measured before and after treatment. To observe the relationship between the therapeutic effect of microwave ablation combined with 131 I-chTNT in comprehensive treatment of non-small cell lung cancer and the level of tumor markers by comparing their changes. Methods 78 cases of metaphase and advanced phase non-small cell lung cancer patients accepted were collected and divided randomly. Control group(37 cases)was treated with docetaxel combined with cisplatin while research group(41 cases)was treated with microwave ab-lation combined with 131 I-chTNT radioimmunotherapy. The treatment of the two groups of patients was observed and the levels of serum tumor markers such as CEA, CA125 and CYFRA21-1 were measured before and 1,3 and 6 months after treatment. Results The total effective rate of the observation group was 56. 10%, significantly higher than that of the control group which was 48. 65%(P<0. 05). After treatment,the serum tumor markers such as CEA, CA125 and CYFRA21-1 were significantly improved compared with those before treatment in the two groups, and the improvement of the observation group was more obvious ( P <0. 05). Conclusion Microwave ablation combined with 131I-chTNT in the comprehensive treatment of metaphase and advanced phase non-small cell lung cancer has satisfactory curative effect and can effectively reduce the level of a number of tumor markers.