目的 探討培美曲塞聯(lián)合順鉑治療晚期非鱗非小細(xì)胞肺癌對血清腫瘤標(biāo)志物的影響。方法 采用隨機(jī)抽樣、隨訪、回顧性調(diào)查研究方法，2013年6月—2015年8月選擇在重慶市開州區(qū)人民醫(yī)院進(jìn)行診治的晚期非鱗非小細(xì)胞肺癌患者102例作為研究對象，根據(jù)治療方法的不同分為觀察組與對照組各51例。對照組給予紫杉醇聯(lián)合順鉑的常規(guī)化療；觀察組給予培美曲塞聯(lián)合順鉑治療，21 d為1個治療周期，兩組都治療觀察4個周期。比較兩組臨床療效和毒副反應(yīng)情況，采用酶聯(lián)免疫吸附（ELISA）法測定癌胚抗原（CEA）、載脂蛋白A1（ApoA1）表達(dá)情況，隨訪并比較兩組的生存期。結(jié)果 治療后觀察組與對照組的總有效率分別為76.5%和41.2%，觀察組高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療期間觀察組的皮膚反應(yīng)、骨髓抑制、消化道反應(yīng)等毒副反應(yīng)情況與對照組相比無統(tǒng)計(jì)學(xué)意義。觀察組與對照組治療后的CEA值都低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后觀察組的CEA低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組與對照組治療后的ApoA1值都高于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后觀察組的ApoA1高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組與對照組的中位生存期分別為（16.44±2.12）個月和（11.94±3.19）個月，KM法分析顯示觀察組高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 培美曲塞聯(lián)合順鉑治療晚期非鱗非小細(xì)胞肺癌應(yīng)用能降低血清腫瘤標(biāo)志物CEA表達(dá)水平，提高ApoA1表達(dá)水平，提高治療療效，且不會增加毒副反應(yīng)的發(fā)生，從而延長患者的生存期。

Objective To investigate the effects of pemetrexed combined with cisplatin on serum tumor markers in patients with advanced non squamous non-small cell lung cancer.Methods Used the random sampling, follow-up and retrospective study method, From June 2013 to August 2015,102 patients with advanced non squamous non-small cell lung cancer in our hospital for diagnosis and treatment were divided into observation group and control group of 51 patients in each groups accorded to the different treatment methods. The control group given paclitaxel plus cisplatin standard chemotherapy. Observation group was given pemetrexed combined cisplatin treatment, 21 d was 1 treatment cycles, and the two groups were treated for 4 cycles.Results After treatment, the total effective rates in the observation group and the control group were 60.8% and 41.2%, respectively, and the observation group was higher than that of the control group (P<0.05). During the treatment, the adverse reactions such as skin reaction, bone marrow suppression and digestive tract reaction in the observation group were not significantly different from those in the control group. Observation group and control group after treatment serum CEA values are lower than before treatment, after treatment the CEA group than controls (P<0.05), the observation group and control group after treatment of ApoA1 values are higher than that of before treatment, after treatment group ApoA1 is higher than the control group (P<0.05).The median survival times in the observation group and the control group were (16.44 ±2.12) months and (11.94 ±3.19) months, respectively. The KM analysis showed that the observation group was higher than that of the control group (t=5.388, P<0.05).Conclusion Pemetrexed combined with cisplatin treatment of advanced application scale non-small cell lung cancer can lower serum tumor markers CEA expression level and improve the level of expression of ApoA1, improve curative effect, and do not increase the occurrence of adverse reaction, so as to prolong patient survival.