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目的探讨肺癌患者应用GP方案(吉西他滨+顺铂)化疗前、后神经元特异性烯醇化酶(neuron-specific enolase,NSE)与细胞角蛋白19片段(cytokeratin-19-fragment,CYFRA21-1)表达变化及意义。方法非小细胞肺癌(non-small cell lung cancer,NSCLC)患者68例,其中腺癌36例(腺癌组)和鳞癌32例(鳞癌组),小细胞肺癌(small cell lung cancer,SCLC)患者32例(SCLC组)。3组均采用GP方案化疗,吉西他滨1g/m~2,静脉滴注,第1,8天;顺铂25mg/m~2,静脉滴注,第1~3天;每21d为1个周期。化疗2个周期后评定3组疗效,比较3组化疗前、后血清NSE和CYFRA21-1水平。结果化疗2个周期,腺癌组和鳞癌组疾病控制率(58.33%、56.25%)高于SCLC组(31.25%)(P<0.05),腺癌组与鳞癌组比较差异无统计学意义(P>0.05);化疗后3组血清NSE、CYFRA21-1水平均低于化疗前(P<0.05);3组部分缓解(partial response,PR)、疾病稳定(stable disease,SD)和疾病进展(progressive disease,PD)患者化疗前血清NSE、CYFRA21-1水平比较差异均无统计学意义(P>0.05);化疗后腺癌组、鳞癌组和SCLC组PR患者血清NSE[(17.60±2.35)、(17.62±2.32)、(27.60±3.35)μg/L]、CYFRA21-1[(2.80±0.65)、(2.73±0.64)、(1.80±0.65)μg/L]水平低于SD[腺癌组:(24.60±3.65)、(5.60±1.04)μg/L;鳞癌组:(24.62±3.62)、(5.59±.042)μg/L;SCLC组:(35.60±3.65)、(3.60±0.47)μg/L]、PD[腺癌组:(32.61±4.32)、(8.90±2.08)μg/L;鳞癌组:(30.60±4.31)、(8.79±2.11)μg/L;SCLC组:(53.40±4.32)、(4.60±0.62)μg/L]患者,SD患者低于PD患者(P<0.05)。结论 NSCLC患者应用GP方案化疗的效果优于SCLC,NSE、CYFRA21-1水平一定程度上可反映肺癌患者GP方案化疗的疗效。
Objective To investigate the expression of neuron-specific enolase (NSE) and cytokeratin-19-fragment (CYFRA21-1) in patients with lung cancer before and after chemotherapy with GP regimen (gemcitabine plus cisplatin) Change and significance. Methods Sixty-eight patients with non-small cell lung cancer (NSCLC) were enrolled, including 36 cases of adenocarcinoma (adenocarcinoma) and 32 cases of squamous cell carcinoma (SCC), small cell lung cancer (SCLC) ) 32 patients (SCLC group). 3 groups were treated with GP chemotherapy, gemcitabine 1g / m ~ 2, intravenous drip, first and eighth days; cisplatin 25mg / m ~ 2, intravenous drip, 1 to 3 days; every 21d for a cycle. After 2 cycles of chemotherapy, the efficacy of three groups was evaluated. The levels of serum NSE and CYFRA21-1 in the three groups before and after chemotherapy were compared. Results The rates of disease control in adenocarcinoma group and squamous cell carcinoma group (58.33%, 56.25%) were higher than those in SCLC group (31.25%) (P <0.05) at 2 cycles of chemotherapy. There was no significant difference between adenocarcinoma group and squamous cell carcinoma group (P> 0.05). The serum levels of NSE and CYFRA21-1 in three groups after chemotherapy were lower than those before chemotherapy (P <0.05). The partial response (PR), stable disease (SD) and disease progression The serum levels of NSE and CYFRA21-1 in patients with progressive disease (PD) before chemotherapy were not significantly different (P> 0.05). After chemotherapy, the serum levels of NSE in patients with adenocarcinoma, squamous cell carcinoma and SCLC [ ), (17.62 ± 2.32), (27.60 ± 3.35) μg / L], CYFRA21-1 [(2.80 ± 0.65), (2.73 ± 0.64), (1.80 ± 0.65) μg / L] Group: (24.60 ± 3.65) and (5.60 ± 1.04) μg / L; squamous cell carcinoma group (24.62 ± 3.62) and (5.59 ± 0.42) μg / ) were significantly lower than those in the control group (P <0.05), P <0.05), P <0.01) 53.40 ± 4.32), (4.60 ± 0.62) μg / L], SD patients were lower than PD patients (P <0.05). Conclusion The efficacy of GP regimen in patients with NSCLC is better than that of SCLC. The levels of NSE and CYFRA21-1 may reflect the efficacy of GP regimen in patients with lung cancer.