微创医学

目的观察肺癌根治术联合125I粒子植入的术后影响。方法选择52例非小细胞肺癌(NSCLC)ⅠB～ⅢA期患者,随机分成观察组(27例)与对照组(25例)。两组病例均进行肺癌根治术以及术后4个周期的化疗,其中观察组术中在纵隔淋巴引流部位植入125I粒子,观察术后肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)、糖类抗原199(CA199)的水平以及肿瘤局部控制率在不同时期的变化。结果术后3个月两组病例肿瘤标志物水平比术前明显下降。组内术后不同时间段、各组间术前、术后各时间段血清中肿瘤标志物水平无统计学意义,术后12个月,在有纵隔淋巴结转移的病例中,肿瘤局部控制率观察组(89.47%)高于对照组(56.26%),差异有统计学意义(P<0.05)。结论肺癌根治术联合125I粒子植入,对存在纵隔淋巴结转移的病例可以减少术后局部复发,延长无瘤生存期。

Objective To investigate the effects of the radical resection of lung cancer combined with 125 I implantation． Methods Fifty-two cases of non-small cell lung cancer ( NSCLC) in stageⅠB-ⅢA were randomly divided into observation group and control group，27 and 25 cases respectively． Patients in both groups were performed with radical resection of lung cancer and four cycles of chemotherapy，and 125 I was implanted in the mediastinal lymphatic drainage area only in observation group． Local tumor control rate and tumor markers levels，like CEA，CA125，CA153，CA199，of the two groups in different period were measured and compared． Results Three months after operation，the tumor markers levels in each groups decreased significantly compared with pre-operation( P ＜ 0． 05) ． There was no differences in preoperative or postoperative tumor markers levels between two groups or within each group in each periods． But，12 months after surgery，for patients with mediastinal lymph node micrometastasis，the tumor local control rate in the observation group ( 89． 47%) was higher than that in the control group ( 56． 26%) ，which was statistically significant ( P ＜ 0． 05) ． Conclusions For patients with mediastinal lymph node micrometastasis，lung cancer radical operation combined with 125 I implantation could prolong tumor-free survival period and decreased the risk of local recurrence．