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Objective:To investigate the values of serum neuron specific enolase (NSE), circulating tumor cells (CTC) and lactate dehydrogenase (LDH) levels in the diagnosis and treatment of small cell lung cancer (SCLC).Methods:Ninety patients with SCLC who received treatment in the Second Affiliated Hospital of Zhejiang Chinese Medical University, China between December 2017 and December 2019 were retrospectively included in the observation group. Ninety healthy subjects who concurrently received lung examination in the same hospital were included in the healthy control group. An additional 90 patients with benign lung disease were included in the benign lung disease group. Serum NSE, CTC and LDH levels were determined in each group. The values of serum NSE, CTC and LDH levels in the diagnosis of SCLC were analyzed. Serum NSE, CTC and LDH levels were compared between before and after chemotherapy and their values in the treatment of SCLC were analyzed.Results:There were significant differences in serum NSE, CTC and LDH levels between three groups ( F = 359.789, 188.873 and 768.704, all P < 0.001). Serum NSE, CTC and LDH levels in the benign lung disease group were significantly greater than those in the healthy control group and significantly lower than those in the observation group. The receiver operating characteristic curve (ROC curve) analysis showed that the AUC values of serum NSE, CTC and LDH levels in the diagnosis of SCLC were 0.995, 0.953 and 0.987, respectively. The diagnostic accuracy was very high. The value at the maximum tangent point of Youden's index of serum NSE, CTC and LDH levels at the left-upper corner of the ROC curve was taken as the most appropriate cut-off value. The sensitivity and specificity of the most appropriate cut-off value of serum NSE, CTC and LDH levels in the prediction of SCLC were 100.0%/94.4%/91.1% and 94.4%/88.3%/100.0%, respectively. Therefore, serum NSE, CTC and LDH levels were of high values in the predication of SCLC. After chemotherapy, serum NSE, CTC and LDH levels in patients with SCLC were significantly lower than those before chemotherapy [NSE: (12.26 ± 3.26) μg/L vs. (18.36 ± 4.64) μg/L; CTC: (3.54 ± 1.08) counts/5 mL vs. (7.34 ± 1.30) counts/5 mL; LDH: (24.61 ± 9.66) U/L vs. (50.29 ± 16.29) U/L, t = 10.205, 12.864, 21.330, all P < 0.001). Serum NSE, CTC and LDH levels in SCLC patients in whom treatment was effective were significantly lower than those in SCLC patients in which treatment was not effective ( t = 8.111, 7.347, 10.731, all P < 0.001). Spearman correlation results showed that serum NSE, CTC and LDH levels were significantly negatively correlated with curative effects ( r = -0.562, -0.562, -0.758, all P < 0.05). Conclusion:Serum NSE, CTC and LDH levels are highly expressed in SCLC patients, which can be used as markers for early clinical diagnosis and treatment of SCLC.
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Objective]To explore the pathogenesis and rules of syndrome and treatment of different groups and stages of patients with malignant tumor,we hope to broden the clinical thinking and improve clinical therapeutic effect. [Methods]Starting from the theory of Chinese medicine,combined with the author's clinical experience,according to patients’selection treatment,we summarize the syndrome patterns, treatment principle and prognosis of different groups and different treatment stages.We divided it into two categories: pure Chinese medicine treatment and traditional Chinese and western medicine treatment. [Outcome]There were many types of malignant tumors,whose pathogenesis and treatment law can be changed under the intervention of treatment measures. Pure Chinese medicine treatment groups were divided into early, middle and late three stages.Combination of traditional Chinese and western medicine treatment was divided into Perioperative group,Tumor free survival group and Survival group with tumor.There were 3 stages in the tumor free survival groups:adjuvant chemotherapy, adjuvant radiotherapy, and no tumor rehabilitation.The survival of the tumor bearing groups was divided into five stages:neoadjuvant chemotherapy,palliative anticancer therapy,maintenance therapy of traditional Chinese medicine,malliative symptom control and the final stage. [Conclusion] Traditional Chinese medicine treatment of malignant tumor is divided into two categories, four groups, thirteen phases.Group and phased treatment based on classification is easy to master and conducive to optimizing the traditional Chinese medicine diagnosis and treatment program.
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This article explores the therapy mechanism and principle of Ze Qi Decoction syndrome in Diseases,Synopsis of Golden Chamber.The position,pathogenesis and diseases about Ze Qi Decoction syndrome are revealed.The feasibility of Ze Qi Decoction in treating lung cancer is proposed by clinical experience and experimental results.The four principles of Ze Qi Decoction(removing water retention and improving yang,dispersing phlegm and eliminating stagnation,invigorating the spleen and strengthening body resistance,clearing stagnated heat)can be summarized as cold and heat in combination,reinforcement and elimination in combination.The main clinical application of Ze Qi Decoction is to treat lung cancer,metastastic tumor of lung and so on.The treatment methods focus on regulating the activities of qi in the organs.The spleen is the foundation of acquired constitution;the treatmeng principal should be based on the spleen.Herba Euphoribiae Helioscopiae should be decocted first to remove the toxicity to protect the stomach.
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This article summarized the clinical experience of HE Ren, including the principle of treating liver cancer with ascites and the common used drugs and laws. During the physiological and pathologic process of ascitic formation, the liver, spleen and kidney were the center, and the main treatment methods were regulating qi-flowing, eliminating dampness and inducing diuresis.
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Thirty one cases of colon carcinoma were treated withChangliuping,combined with surgical operation andchemotherapy.The survuval rates of 1,3,and 5 years100%,81.25% and 65.0% respectively.Resultsshowed that this decoction is capable of improving thephysical condition,lowering the level of CEA,withcertain adjusting action on immunity,while experi-ments proved that the decoction yields marked inhibi-tion on S_(180),Lewis and EAC,on spontaneous metast-sis and marked elevation of cytoimmunity in tumorbearing mice.