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目的:探讨晚期肿瘤患者化疗后肿瘤标记物一过性升高的临床意义。方法:回顾性分析自2006年10月~2008年10月于我科入院化疗的患者肿瘤标记物的变化情况,以化疗后肿瘤标记物较基线数值升高>20%,紧接着较基线下降>20%为肿瘤标记物一过性升高的标准,观察其发生率,分析肿瘤标记物一过性升高与化疗客观疗效的关系以及肿瘤标记物一过性升高的临床过程。结果:符合入选标准的患者共94例。其中9例患者出现了肿瘤标记物的一过性升高,客观疗效评价均为SD或PR。肺癌、胃癌、大肠癌、乳腺癌均可见到化疗诱导的肿瘤标记物一过性升高的现象,其发生率分别为肺癌14%(4/28),胃癌10%(2/20),结肠癌7.6%(1/13),直肠癌10%(1/10),乳腺癌13%(1/8)。9例患者中共出现11次肿瘤标记物一过性升高,达峰时间为(42.9±15.4)天,回落时间为(84.0±26.1)天。结论:常见的晚期肿瘤患者均可见到化疗诱导的肿瘤标记物一过性升高现象,肿瘤标记物一过性升高为化疗有效的标志。化疗初始阶段的肿瘤标记物升高并不一定提示化疗无效,应该结合患者影像学和症状等临床资料综合判断疗效。
Objective: To investigate the clinical significance of transient increase of tumor markers in patients with advanced cancer after chemotherapy. Methods: The changes of tumor markers in patients admitted to our hospital from October 2006 to October 2008 were retrospectively analyzed. Tumor markers increased by> 20% compared with the baseline value after chemotherapy, and then decreased from baseline> 20% is a transient increase of tumor markers, observe the incidence, analyze the relationship between the transient increase of tumor markers and the objective effect of chemotherapy, and the clinical process of transient increase of tumor markers. Results: A total of 94 patients met the inclusion criteria. Among them, 9 patients had a transient increase of tumor markers, and objective evaluation of efficacy was SD or PR. Lung cancer, gastric cancer, colorectal cancer, breast cancer can be seen chemotherapy induced tumor marker transient increase in the incidence of lung cancer were 14% (4/28), gastric cancer 10% (2/20), colon Cancer 7.6% (1/13), rectal cancer 10% (1/10), breast cancer 13% (1/8). A total of 11 tumor markers were transiently elevated in 9 patients. The peak time was (42.9 ± 15.4) days and the fall time was (84.0 ± 26.1) days. CONCLUSIONS: Chemotherapy-induced transient increase of tumor markers can be seen in common advanced cancer patients. The transient increase of tumor markers is an effective marker of chemotherapy. The initial stage of chemotherapy, tumor markers does not necessarily prompt chemotherapy ineffective, should be combined with the patient’s imaging and clinical data to determine the efficacy of symptoms.