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目的:观察中药消积饮治疗晚期非小细胞肺癌的循环血管内皮细胞(CECs)数量变化与CEA、CYFRA 21-1、NSE、客观应答率(ORR)、无进展生存期(PFS)的关系,旨在探讨CECs作为评价消积饮治疗晚期NSCLC的抗血管生成作用的临床应用价值。方法:50例晚期NSCLC患者,随机分为试验组和治疗组,试验组25例,对照组25例。试验组给予消积饮联合TP方案化疗治疗,对照组给予单纯TP方案化疗治疗,首要观察指标两组CECs的表型(CD_(146)~+)的数量变化,次要观察指标包括CD_(146)~+与CEA、CYFRA 21-1、NSE数值变化关系、CD_(146)~+与客观应答率(RECIST标准)关系、CD_(146)~+与无进展生存期关系及毒副反应。结果:全部50例随机患者参与评价。首要观察指标CD_(146)~+值治疗后试验组(0.76±0.35)明显低于对照组(1.93±2.39),具统计学差异(P<0.05)。次要观察指标,CD_(146)~+与CEA、NSE呈线性正相关,相关系数为0.99、0.34(P<0.05);CD_(146)~+与CYFRA21-1未见明显相关性;CD_(146)~+与ORR无明确相关性;CD_(146)~+与PFS是负性相关,PFS的偏相关系数分别为-1.16(P<0.05)。两组均无严重不良反应及毒副反应。结论:CD_(146)~+可作为新的一种评价中药抗肺癌肿瘤血管生成作用、指导临床用药的手段。
Objective: To observe the relationship between the number of circulating vascular endothelial cells (CECs) and the CEA, CYFRA 21-1, NSE, objective response rate (ORR) and progression-free survival (PFS) in the treatment of advanced non-small cell lung cancer The aim of this study was to investigate the clinical value of CECs as an anti-angiogenic agent in the evaluation of Xiaoji Yin in the treatment of advanced NSCLC. Methods: Fifty patients with advanced NSCLC were randomly divided into experimental group and treatment group, with 25 cases in trial group and 25 cases in control group. The experimental group was given Xiajiangyin combined with TP regimen chemotherapy, while the control group was given TP regimen chemotherapy. The primary observation index was the change of the number of C_ (146) ~ + ) ~ + And CEA, CYFRA 21-1 and NSE, the relationship between CD 146 (+) and objective response rate (RECIST), the relationship between CD 146 and progression-free survival and toxicity. Results: All 50 randomized patients were involved in the evaluation. The primary observation index CD_ (146) ~ + value after treatment was significantly lower in experimental group (0.76 ± 0.35) than in control group (1.93 ± 2.39), with statistical difference (P <0.05). There was a positive correlation between CD 146 (+) and CEA and NSE, the correlation coefficient was 0.99,0.34 (P <0.05). No significant correlation was found between CD 146 and CYFRA 21-1 CD_ (146) 146) ~ + had no significant correlation with ORR; CD 146 (146 +) was negatively correlated with PFS, PFS partial correlation coefficients were -1.16 (P <0.05) respectively. No serious adverse reactions and side effects were observed in both groups. Conclusion: CD 146 (superscript +) can be used as a new method to evaluate antiangiogenic effect of traditional Chinese medicine against lung cancer and to guide clinical application.