腹腔灌注在卵巢癌患者中的临床疗效及对血清bFGF HE4 AFP的影响

doi:10.3969/j.issn.1006-6233.2019.12.008

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摘要目的:研究腹腔灌注在卵巢癌患者中的应用疗效及血清碱性成纤维细胞生长因子(bFGF)、人附睾蛋白4(HE4)、甲胎蛋白(AFP)的影响。方法:回顾性分析我院2014年3月至2015年3月收治的90例卵巢癌患者,根据治疗方法分为实验组和对照组,每组各45例。两组在均予以水化(静脉滴注20mL氯化钾+1000mL生理盐水)、利尿、止吐等,采用肿瘤细胞减灭术。对照组在此基础上,术后采用新辅助化疗治疗。实验组采用术前新辅助化疗联合腹腔灌注治疗,术后继续TP方案治疗。每个周期为28天,两组治疗疗程为6~8周期。对比两组手术指标(手术时间、术中出血量、腹水量),血清bFGF、HE4、AFP水平,不良反应发生率,治疗疗效。结果:实验组手术时间、术中出血量、腹水量显著低于对照组[(136.08±17.35)min vs(160.26±20.64)min,(540.21±121.36)mL vs(610.36±134.08)mL,(510.32±113.65)mL vs(917.87±132.48)mL](P<0.05);bFGF、HE4、AFP水平均显著低于对照组[(65.90±9.36)ng/L vs(96.34±12.75)ng/L,(42.69±8.17)pmoL/L vs(75.38±13.49)pmoL/L,(5.83±1.02)ng/mL vs(13.97±3.57)ng/mL](P<0.05);不良反应总发生率显著低于对照组[20.00%(9/45)vs46.66%(21/45)](P<0.05); 总缓解率显著高于对照组[91.11%(41/45)vs71.11%(32/45)](P<0.05)。结论:腹腔灌注在卵巢癌患者中的应用疗效显著,可有效改善患者的临床症状,降低血清bFGF、HE4、AFP的水平,促进肿瘤细胞凋亡,抑制血管形成,减少毒副反应,从而改善预后。

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关键词 ：腹腔灌注, 卵巢癌, 毒副反应

Abstract：Objective: To research the effect of intraperitoneal perfusion in patients with ovarian cancer and its effect on serum fibroblast growth factor(Bfgf), Humanepididymisprotein4(HE4) and alpha fetoprotein(AFP). Methods:According to the treatment methods, 90 patients with ovarian cancer admitted to our hospital from March 2014 to March 2015 were divided into experimental group and control group, 45 cases in each group. Both groups were given hydration (intravenous drip of 20 mL potassium chloride + 1000 mL normal saline), diuresis, antiemetic, etc., and tumor cell reduction surgery. On this basis, the control group was treated with neoadjuvant chemotherapy. The experimental group was treated with neoadjuvant chemotherapy and intraperitoneal perfusion before operation, and continued to be treated with TP after operation. Each cycle was 28 days, and the treatment course of the two groups was 6-8 cycles. The operation indexes (operation time, intraoperative bleeding volume, ascites volume), serum bFGF, HE4, AFP levels, adverse reactions and therapeutic effect were compared between the two groups. Results: The operation time, the amount of blood loss and the volume of ascites in the experimental group were significantly lower than those in the control group[(136.08±17.35)min vs(160.26±20.64)min,(540.21±121.36)mL vs(610.36±134.08)mL,(510.32±113.65)mL vs(917.87±132.48)mL](P<0.05); The levels of bFGF, HE4 and AFP were significantly lower than those of the control group[(65.90±9.36)ng/L vs(96.34±12.75)ng/L,(42.69±8.17)pmol/L vs(75.38±13.49)pmol/L,(5.83±1.02)ng/mL vs(13.97±3.57)ng/mL](P<0.05); The total incidence of adverse reactions was significantly lower than that of the control group [20.00%(9/45)vs 46.66%(21/45)](P<0.05); Total remission rate was significantly higher than that of the control group [91.11%(41/45)vs 71.11%(32/45)](P<0.05). Conclusion: The application of intraperitoneal perfusion in patients with ovarian cancer has a significant effect, which can effectively improve the clinical symptoms of patients, reduce the level of serum bFGF, HE4, AFP, promote the apoptosis of tumor cells, inhibit the formation of blood vessels, reduce toxic and side effects, and improve the prognosis.

Key words： Intraperitoneal perfusion Ovarian cancer Toxic side effects

基金资助:广东省自然科学基金博士启动项目,(编号:2016A030310242)

通讯作者: 王树滨

引用本文:

余少康, 靳枫, 李柱, 潘毅贞, 王树滨, 邱莉. 腹腔灌注在卵巢癌患者中的临床疗效及对血清bFGF HE4 AFP的影响[J]. 河北医学, 2019, 25(12): 1965-1969.
YU Shaokang, JIN Feng, LI Zhu, et al. Effect of Intraperitoneal Perfusion in Patients with Ovarian Cancer and its Effect on Serum bFGF HE4 and AFP. HeBei Med, 2019, 25(12): 1965-1969.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.12.008 或 http://www.hbyxzzs.cn/CN/Y2019/V25/I12/1965

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