目的：探讨紫杉醇联合铂类化疗方案对中晚期宫颈癌患者的疗效及血清细胞角蛋白19片段抗原21-1（CYFRA21-1）、鳞状上皮癌抗原（SCCAg）的影响。方法将2011年4月至2014年4月鞍山市第三医院妇收治的94例中晚期宫颈癌患者按照随机数字表法分为研究组和对照组，各47例。对照组采用MFP方案（丝裂霉素＋5-氟尿嘧啶＋顺铂），研究组采用紫杉醇联合铂类化疗方案，两组患者均治疗3周为1个疗程。比较两组患者临床疗效及不良反应发生率，分别于化疗前后检测两组患者外周血T淋巴亚群及血清CYFRA21-1、SCCAg水平。结果研究组总有效率为68.0％（32／47），对照组总有效率为59.6％（28／47），两组患者总有效率比较差异无统计学意义（P＞0.05）；研究组疾病控制率显著高于对照组[95.7％（45／47）比78.7％（37／47），P＜0.05]。治疗后研究组外周血CD3＋、CD4＋、CD4＋／CD8＋显著高于对照组[（73.8±11.5）％比（62.7±10.4）％，（49.2±8.1）％比（39.4±7.3）％，（2.1±0.3）比（1.5±0.2）]，CD8＋显著低于对照组[（23.7±5.0）％比（27.1±6.7）％]，差异有统计学意义（P＜0.01）。治疗后研究组血清 CYFRA21-1、SCCAg 显著低于对照组[（0.9±0.1） mg／L比（1.8±0.3） mg／L，（3.3±0.4） mg／L比（5.6±0.6） mg／L]（P＜0.01）。两组患者化疗期间主要不良反应有胃肠道反应、骨髓抑制、肝肾功能损害、外周神经炎、脱发等，其中研究组各不良反应发生率与对照组比较差异无统计学意义（ P ＞0.05）。结论紫杉醇联合铂类化疗方案治疗中晚期宫颈癌临床疗效更佳，值得临床推广。%Objective To explore the clinical efficacy of paclitaxel combining cisplatin regimen for advanced cervical cancer patients and its effect on serum cytokeratin fragment antigen 21-1 ( CYFRA21-1 ) , squamous cell carcinoma antigen(SCCAg) levels.Methods A total of 94 advanced cervical cancer patients treated in Anshan Third Hospital from Apr.2011 to Apr.2014 were randomly divided into study group of 47 cases and control group of 47 cases according to random number table method:the control group was treated with MFP regimen( mitomycin+5-fluorouracil+platinum) ,the observation group was treated with paclitaxel combined with platinum chemotherapy ,3 weeks as 1 course for both groups.The clinical efficacy and adverse reactions of the two groups were compared,and the levels of CYFRA21-1,SCCAg and peripheral blood T lymphocyte subsets were detected in the two groups before and after chemotherapy .Results The total effec-tive rate was 68.0%(32/47) in the study group,59.6%(28/47) in the control group,and there was no sig-nificant difference between the two groups(P>0.05);the disease control rate was 95.7%(45/47) in the study group,78.7%(37/47) in the control group,the study group was significantly higher than the control group (P<0.05).After treatment peripheral blood CD3+(73.8 ±11.5)%,CD4+(49.2 ±8.1)%,CD4+/CD8+(2.1 ±0.3) of the study group were significantly higher than those in the control group [(62.7 ± 10.4)%,(39.4 ±7.3)%,(1.5 ±0.2)],CD8+(23.7 ±5.0)% was significantly lower than the control group (27.1 ±6.7)%,and the differences between the two groups were statistically significant (P<0.01). After treatment,serum CYFRA21-1 (0.9 ±0.1) mg/L,SCCAg(3.3 ±0.4) mg/L in the study group were significantly lower than those in the control group[ (1.8 ±0.3) mg/L,(5.6 ±0.6) mg/L](P<0.01). The main adverse reactions of the two groups included gastrointestinal reaction ,bone marrow inhibition,dam-age to liver and kidney function,peripheral neuritis,hair loss,and there was no significant difference between the study group and the control group in adverse reactions(P>0.05).Conclusion The clinical efficacy of paclitaxel combined with platinum chemotherapy in the treatment of advanced cervical cancer is better ,thus is worthy of clinical promotion.
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