非小細胞肺癌晚期吉西他濱聯(lián)合鉑類化療后血清SIL—2R、TNF—α水平的臨床意義

[摘要] 目的 測定非小細胞肺癌患者晚期吉西他濱聯(lián)合鉑類化療前后血清中SIL-2R、TNF-α水平并分析其臨床意義。 方法 方便選取2014年6月—2016年6月于該院就診的非小細胞肺癌晚期患者160例為觀察組，選取同期于該院體檢的健康人80名作為對照組，統(tǒng)計化療前后患者病情緩解情況，采用ELISA方法測定化療前后血清中的SIL-2R、TNF-α水平，對比分析其臨床意義。結(jié)果 化療后病情完全緩解者0例（0.00%）；部分緩解者46例（25.56%）；疾病穩(wěn)定者62例（34.44%）；疾病進展者72例（40.00%）。疾病控制率為60.00%；觀察組患者化療前血清SIL-2R（698.35± 100.32）U/mL和TNF-α（251.02±25.62）ng/L水平顯著高于對照組[SIL-2R（205.34±82.10）U/mL；TNF-α（72.33±15.24）ng/L]（P<0.05）；觀察組患者化療后[SIL-2R（420.26±115.28）U/mL；TNF-α（125.22±19.03）ng/L]和化療前[SIL-2R （698.35± 100.32）U/mL；TNF-α（251.02±25.62）ng/L]相比各項指標均顯著下降（P<0.05），但仍顯著高于對照組（P<0.05）；觀察組化療后血清SIL-2R（698.35±100.32）U/mL和TNF-α（251.02±25.62）ng/L水平下降幅度與病情緩解度呈負相關（r=-0.675，r=-0.723；P<0.05）。 結(jié)論 非小細胞肺癌患者晚期吉西他濱聯(lián)合鉑類化療后血清SIL-2R、TNF-α水平顯著低于化療前，下降幅度與病情緩解情況呈負相關，可作為非小細胞肺癌患者晚期化療療效的評估指標。

[關鍵詞] 非小細胞肺癌晚期；吉西他濱；鉑類；SIL-2R；TNF-α

[中圖分類號] R246.1 [文獻標識碼] A [文章編號] 1674-0742（2016）12（c）-0010-04

[Abstract] Objective To test the levels of SIL-2R and TNF-α in serum of patients with non-small cell lung cancer before and after chemotherapy with gemcitabine and to analyze its clinical significance. Methods Patients with advanced non-small cell lung cancer from June 2014 to June 2016 in our hospital 160 cases of the observation group， healthy people were selected in our hospital physical examination in 80 cases as control group， statistics before and after chemotherapy remission before and after chemotherapy， determination of serum SIL-2R， TNF-α levels by using ELISA method， comparative analysis and its clinical significance. Results After chemotherapy， 0 patients （0.00%） with complete remission （46）， partial remission （25.56%）， 62 cases （34.44%） with stable disease， 72 cases （40.00%）. The disease control rate was 60.00%； the serum SIL-2R（698.35±100.32）U/mL and TNF-α（251.02±25.62）ng/L levels of observation group before chemotherapy were significantly higher than the control group[SIL-2R （205.34±82.10）U/mL；TNF-α（72.33±15.24）ng/L] （P < 0.05）；The indexes of patients in the observation group after chemotherapy[SIL-2R（420.26±115.28）U/mL；TNF-α（125.22±19.03）ng/L] compared with before chemotherapy[SIL-2R（698.35±100.32）U/mL；TNF-α（251.02±25.62）ng/L] were significantly decreased （P < 0.05）， but still significantly higher than the control group（P<0.05）； In the observation group， the level of serum SIL-2R（698.35±100.32）U/mL and TNF-α（251.02±25.62）ng/L decreased after chemotherapy was negatively correlated with the degree of remission（r=-0.675， r=-0.723， P<0.05）. Conclusion Patients with advanced non-small cell lung cancer gemcitabine combined with platinum chemotherapy serum SIL-2R， TNF-α levels were significantly lower than that before chemotherapy， decrease and remission were negatively correlated， can be used to evaluate the index of curative effect in patients with advanced non-small cell lung cancer.

[Key words] Advanced stage of non-small cell lung cancer； Gemcitabine； Platinum； Soluble interleukin-2 receptor； Tumor necrosis factor-α

在肺癌患者中臨床最常見類型為非小細胞肺癌，早期癥狀不明顯，發(fā)現(xiàn)時大多屬于中晚期，手術(shù)治療效果不理想，此時臨床常采用含鉑類兩藥化療方案，療效觀察一般采用影像學檢查，但不易對早期化療效果進行觀察[1-2]。有研究顯示[3]，可溶性白細胞介素-2受體（soluble interleukin-2 receptor，SIL-2R）、腫瘤壞死因子α（tumour necrosis factor-α）與腫瘤的發(fā)生、發(fā)展有密切關系。鑒于此，該文方便選取2014年6月—2016年6月于該院就診的160例非小細胞肺癌晚期患者作……