放疗联合高强度聚焦超声治疗胰腺癌的研究

Study of radiotherapy combined with high-intensity focused ultrasound on the treatment of pancreatic carcinoma

摘要:

目的 探讨放疗联合高强度聚焦超声治疗胰腺癌的疗效。方法 将南京医科大学附属淮安第一医院收治的100例中晚期胰腺癌患者随机分为观察组及对照组，每组50例。对照组采用放疗，观察组在对照组的基础上联合高强度聚焦超声治疗；治疗前后检测患者血清学指标、影像学指标，观察临床症状及不良反应。结果 治疗后两组患者血清糖类抗原199（CA199）、糖类抗原242（CA242）、骨桥蛋白（OPN）、中性粒细胞明胶酶相关运载蛋白（NGAL）及视黄醇结合蛋白4（RBP4）水平比较，差异有统计学意义（P?<0.05），观察组低于对照组。两组患者血清谷丙转氨酶（ALT）、天门冬氨酸氨基转移酶（AST）、血尿素氮（BUN）及肌酐（Cr）水平比较，差异有统计学意义（P?<0.05），观察组低于对照组。两组治疗前后血清中DJ-1及microRNA-155（miR-155）比较，差异有统计学意义（P?<0.05）。治疗后两组患者血清DJ-1及miR-155水平均有所降低，且治疗后观察组低于对照组。观察组患者回声均有不同程度增强，其中5例肿瘤组织内出现小的无回声区。对照组患者回声未出现明显增强。观察组患者疼痛完全缓解率为89%（41/46），对照组患者疼痛程度无明显缓解。观察组患者食欲均出现不同程度的改善，体重均出现不同程度的增加，对照组患者饮食及体重无明显改变。治疗后，观察组平均体重重于对照组（P?<0.05）。结论 采用调强放疗联合高强度聚焦超声治疗胰腺癌后可有效提高临床疗效，并降低患者血清DJ-1及miR-155水平。

Abstract:

Objective To investigate the efficacy of radiotherapy combined with high intensity focused ultrasound (HIFU) in the treatment of pancreatic cancer. Methods Totally 100 patients with advanced pancreatic cancer treated in our hospital were randomly divided into the observation group and the control group. The control group was treated with radiotherapy, and the observation group was treated with radiotherapy combined with high intensity focused ultrasound. Serological index, medical imaging index, clinical symptoms and adverse reactions were detected before and after treatment. Results After treatment, the levels of CA199, CA242, OPN, NGAL and RBP4 in the blood of the observation group were lower than those of the control group (P?