许金凤 李海涛 邓印根

【摘要】 目的：研究紫杉醇或培美曲塞聯合奈达铂治疗晚期肺腺癌的效果及对肿瘤标志物水平的影响。方法：选取笔者所在医院2015年1月-2019年1月收治的晚期肺腺癌患者60例，按照随机数字表法分为对照组（30例）及观察组（30例）。对照组应用紫杉醇联合奈达铂化疗方案，观察组应用培美曲塞联合奈达铂化疗方案。比较两组临床疗效、肿瘤标志物水平、不良反应发生情况。结果：两组短期有效率、1年生存率比较差异均无统计学意义（P>0.05）。观察组血清糖类抗原125（CA125）、癌胚抗原（CEA）水平均显著低于对照组，差异有统计学意义（P<0.05）。两组血小板计数减少率、白细胞计数减少率、中性粒细胞计数减少率比较差异均无统计学意义（P>0.05）。结论：培美曲塞联合奈达铂、紫杉醇联合奈达铂治疗晚期肺腺癌均能获得较好效果，但培美曲塞联合奈达铂能更显著降低肿瘤标志物水平，且安全性较好，可临床推广。

【关键词】 紫杉醇 培美曲塞 奈达铂 晚期肺腺癌 肿瘤标志物

doi：10.14033/j.cnki.cfmr.2020.19.002 文献标识码 A 文章编号 1674-6805（2020）19-000-03

Effect of Paclitaxel or Pemetrexed Combined with Nedaplatin in the Treatment of Advanced Lung Adenocarcinoma and Its Effect on Tumor Marker Level/XU Jinfeng， LI Haitao， DENG Yingen. //Chinese and Foreign Medical Research， 2020， 18（19）： -5

[Abstract] Objective： To study the effect of Paclitaxel or Pemetrexed combined with Nedaplatin in the treatment of advanced lung adenocarcinoma and its effect on the level of tumor marker. Method： A total of 60 patients with advanced lung adenocarcinoma admitted in our hospital from January 2015 to January 2019 were selected and divided into the control group （30 cases） and the observation group （30 cases） according to the random number table method. The control group was treated with Paclitaxel combined with Nedaplatin chemotherapy， while the observation group was treated with Pemetrexed combined with Nedaplatin chemotherapy. The clinical efficacy， tumor markers level and adverse reactions were compared between the two groups. Result： There were no significant differences in short-term response rate and 1-year survival rate between the two groups （P>0.05）. The serum levels of carbohydrate antigen 125 （CA125） and carcinoembryonic antigen （CEA） in the observation group were significantly lower than those in the control group， the differences were statistically significant （P<0.05）. There were no significant differences in the incidence of adverse reactions such as platelet count reduction， white blood cell count reduction and neutrophil count reduction between the two groups （P>0.05）. Conclusion： Pemetrexed combined with Nedaplatin and Paclitaxel combined with Nedaplatin can achieve better efficacy in the treatment of advanced lung adenocarcinoma， but Pemetrexed combined with Nedaplatin can significantly reduce the level of tumor markers， and has better safety， which can be popularized clinically.

[Key words] Paclitaxel Pemetrexed Nedaplatin Advanced lung adenocarcinoma Tumor markers

First-authors address： Taishan Peoples Hospital， Taishan 529200， China

肺腺癌属于非小细胞癌（NSCLC），美国国立综合癌症网络（NCCN）肿瘤学临床实践指南确定了以铂类为基础的两药联合方案，并作为晚期NSCLC标准一线治疗方案。紫杉醇联合奈达铂的临床疗效较好，但是肿瘤标志物水平仍较高[1]。培美曲塞能将肿瘤细胞周期阻滞在S期，具有显著的抗肿瘤功能[2]，提示可应用培美曲塞联合奈达铂治疗晚期肺腺癌。本研究选取笔者所在医院2015年1月-2019年1月收治的晚期肺腺癌患者60例，对比紫杉醇联合奈达铂、培美曲塞联合奈达铂两种化疗方案的临床疗效，现将研究结果报告如下。