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目的探讨晚期大肠癌化疗过程中瘤体缩小而癌胚抗原升高患者的相关影响因素。方法 43例晚期大肠癌患者分为观察组(瘤体缩小而癌胚抗原升高组)(21例)和对照组(瘤体缩小而癌胚抗原下降组)(22例),均接受XELOX方案:OXA(奥沙利铂)130 mg/m~2静滴,第1天;希罗达1 000 mg/m~2口服,2次/d,第1~14天,3 w重复,应用至肿瘤进展或出现不能耐受的毒性时停用。观察疗效、不良反应及评价生活质量。结果观察组有效率(47.6%)低于对照组(77.3%)(P<0.05)。观察组卡氏功能状态评分提高+稳定者57.1%(12/21),低于对照组〔72.7%(16/22)〕(P<0.05);观察组不良反应发生率与对照组比较无统计学差异(P>0.05)。两组1年生存率比较有统计学差异(P<0.05)。结论大肠癌化疗后出现瘤体缩小而癌胚抗原升高提示预后不佳,存在因肿瘤异质性导致身体其他部位病灶未控制可能。
Objective To investigate the influencing factors of tumor shrinkage and carcinoembryonic antigen in patients with advanced colorectal cancer during chemotherapy. Methods Forty-three patients with advanced colorectal cancer were divided into two groups: observation group (tumor shrinkage and carcinoembryonic antigen elevated group) (21 cases) and control group (tumor shrinkage and carcinoembryonic antigen reduction group) (22 cases), all underwent XELOX regimen : OXA (Oxaliplatin) 130 mg / m 2 intravenous infusion on day 1; Xeloda 1000 mg / m 2 orally, 2 times / d, days 1-14, 3 w repetition, Discontinue tumor progression or unacceptable toxicity. Observation of efficacy, adverse reactions and evaluation of quality of life. Results The effective rate in observation group (47.6%) was lower than that in control group (77.3%) (P <0.05). The cardiomyocyte functional status scores of the observation group increased 57.1% (12/21) in the stable group, which was lower than that in the control group (72.7%, 16/22) (P <0.05). The incidence of adverse reactions in the observation group was not statistically different from that in the control group Learning difference (P> 0.05). The 1-year survival rates of the two groups were statistically different (P <0.05). Conclusion The tumor shrinks and the carcinoembryonic antigen is elevated after chemotherapy in colorectal cancer, which indicates that the prognosis is not good. The tumor heterogeneity may lead to the uncontrollable lesions in other parts of the body.