重组人血管内皮抑制素联合顺铂对恶性胸腔积液患者VEGF、EGFR及肿瘤标志物的影响  

Influence of recombinant human endostatin combined with cisplatinum on VEGF,EGFR and tumor markers in patients with malignant pleural effusion

作　　者：郑伟 康静波 温居一 王静 

机构地区：[1]解放军海军总医院肿瘤诊疗中心,北京100048

出　　处：《实用临床医药杂志》2016年第23期32-35,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11525930)

摘　　要：目的观察重组人血管内皮抑制素(恩度)联合顺铂腔内灌注治疗恶性胸腔积液的疗效,并探讨其对血清血管内皮生长因子(VEGF)、表皮生长因子受体(EGFR)及肿瘤标志物水平的影响。方法 92例合并恶性胸腔积液的晚期非小细胞肺癌(NSCLC)患者随机分为观察组和对照组,各46例。2组均在B超定位下行胸腔穿刺充分引流后给药,对照组给予顺铂40 mg腔内灌注,第1、4、7天;观察组在此基础上增加恩度45 mg腔内灌注。3次灌注为1个疗程,最多可连续治疗2个疗程。1个疗程结束后评估临床疗效并记录不良反应发生率,对比治疗前后胸腔积液VEGF、EGFR水平及血清肿瘤标志物水平变化,包括癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCC)、神经元特异性烯醇化酶(NSE)。结果观察组总有效率为86.96%,显著高于对照组的69.57%(P<0.05);治疗后2组各指标均下降,且观察组各指标均低于对照组,差异有统计学意义(P<0.05或P<0.01);2组不良反应发生率无显著差异(P>0.05)。结论与顺铂单药相比,恩度联合顺铂腔内灌注治疗可有效提高恶性胸腔积液患者的临床疗效,降低积液内VEGF、EGFR及血清肿瘤标志物的水平,且不增加不良反应。Objective To observe the clinical efficacy of intrapleural perfusion of recombi- nant human endostatin （Endostar） combined with cisplatinum in the treatment of malignant pleural effusion, and to explore its influence on the levels of serum vascular endothelial growth factor （VEGF）, epidermal growth factor receptor （EGFR） and tumor markers. Methods A total of 92 patients with non-small cell lung cancer （NSCLC） complicated with malignant pleural effusion were selected and randomly divided into observation group and control group, with 46 cases for each group. Both groups received drug administration after B ultrasound-oriented thoracocentesis full drainage. Control group was added with intrapleural effusion of cisplatinum 40 mg on 1^st, 4^st,, 7^st days, and ob- servation group was added with intrapleural effusion of Endostar 45 mg, 3 times as one course of treat- ment, for totally 2 courses. After 1-course of treatment, clinical efficacy was evaluated, rates of ad- verse reactions were recorded, and changes of levels of VEGF, EGFR and tumor markers in pleural effusion before and after treatment were compared between two groups, including carcinoembryonic antigen （CEA）, squamous cell carcinoma antigen （SCC） and neuron-specific enolase （NSE）. Re- suits The total response rate was 86.96% in observation group, evidently higher than the 69.57% in control group （ P 〈 0.05 ）. All indexes decreased after treatment in both groups, which decreased more significantly in observation group than those in control group （ P 〈 O. 05 or P 〈 O. 01 ）. However, there was no significant difference between two groups in the rates of adverse reactions （P 〉 0.05）. Conclusion Compared with single cisplatinum, intrapleural perfusion of Endostar combined with cisplatinum can effectively increase the clinical efficacy and reduce the levels of pleural effusion VEGF, EGFR and serum tumor markers without increasing the adverse reactions in patients with ma- lignant pleural effusion.

关 键 词：重组人血管内皮抑制素 顺铂 恶性胸腔积液 血管内皮生长因子 表皮生长因子受体 肿瘤标志物 

分 类 号：R561[医药卫生—呼吸系统]