Zhu Bing, Yang Jianru, Zhang Pei, Shen Lin, Li Xiaolong, Li Jing
Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China.
Central Laboratory of Handan Infectious Diseases Hospital, Handan, Hebei 056800, P.R. China.
Oncol Lett. 2017 Apr;13(4):2344-2348. doi: 10.3892/ol.2017.5675. Epub 2017 Feb 3.
This study was conducted to evaluate the safety and effectiveness of localized lung resection combined with neoadjuvant chemotherapy in the treatment of stage I-II non-small cell lung cancer (NSCLC). A total of 88 patients, who were admitted to our hospital for first diagnosis and treatment, were selected. The patients were divided into control group (n=40 cases) and observation group (n=48 cases) according to the last digit of the admission number. The control group was treated with minimally invasive localized lung resection by thoracoscope. The observation group underwent the same procedure combined with two cycles of systemic neoadjuvant chemotherapy before the surgery was adopted in the observation group. The effects of both treatments were compared. The operation time, intraoperative blood loss and postoperative drainage volume of observation group were significantly lower than those of the control group (P<0.05). The surgical resection rate and margin negative rate of observation group were higher than those of control group, while the occurrence rate of complications was lower than that of control group; results were statistically significant (P<0.05). The serum neutrophil gelatinase associated lipocalin (lipocalin-2/NGAL), matrix metalloproteinase-9 (MMP-9) and carcinoembryonic antigen (CEA) levels of two groups after the treatment were lower than those before; however, levels in the observation group exhibited a distinct decrease. The difference has statistical significance (P<0.05). The follow-up time of two groups was 3-38 months and the median time was 20.5 months. The tumor survival period of observation group was not prolonged, however, the survival rate and quality rate of life were enhanced; the difference has statistical significance (P<0.05). Localized lung resection combined with neoadjuvant chemotherapy can effectively improve the surgical effect of stage I-II NSCLC, prolong the survival period, enhance the survival rate, decrease the occurrence rate of complications and reduce the tumor related factors lipocalin-2, MMP-9 and CEA levels.
本研究旨在评估局限性肺切除术联合新辅助化疗治疗Ⅰ-Ⅱ期非小细胞肺癌（NSCLC）的安全性和有效性。选取我院首次诊断并治疗的88例患者，根据入院号末位数字分为对照组（n = 40例）和观察组（n = 48例）。对照组采用胸腔镜微创局限性肺切除术治疗，观察组在采用相同手术方法的基础上，术前进行两个周期的全身新辅助化疗。比较两种治疗方法的效果。观察组的手术时间、术中出血量和术后引流量均显著低于对照组（P < 0.05）。观察组的手术切除率和切缘阴性率高于对照组，而并发症发生率低于对照组；结果具有统计学意义（P < 0.05）。两组治疗后血清中性粒细胞明胶酶相关脂质运载蛋白（lipocalin-2/NGAL）、基质金属蛋白酶-9（MMP-9）和癌胚抗原（CEA）水平均低于治疗前；然而，观察组水平下降明显。差异具有统计学意义（P < 0.05）。两组随访时间为3 - 38个月，中位时间为20.5个月。观察组肿瘤生存期未延长，但生存率和生活质量率提高；差异具有统计学意义（P < 0.05）。局限性肺切除术联合新辅助化疗可有效提高Ⅰ-Ⅱ期NSCLC的手术效果，延长生存期，提高生存率，降低并发症发生率，降低肿瘤相关因子lipocalin-2、MMP-9和CEA水平。
