贝伐珠单抗联合化疗对Ⅲb/Ⅳ期非鳞非小细胞肺癌患者疾病控制率及血清T细胞亚群水平的影响  

Effect of bevacizumab combined with chemotherapy on disease control rate and serum T cell subsets in patients with stage Ⅲb/Ⅳ non-squamous non-small cell lung cancer

作　　者：王道峰[1] 伏俊[1] 房三友[1] WANG Dao-feng;FU Jun;FANG San-you(Department of Respiratory Physicians,Taixing people’s Hospital,Taizhou,Jiangsu 225400,China)

机构地区：[1]泰兴市人民医院呼吸内科,江苏泰兴225400

出　　处：《临床肺科杂志》2020年第8期1231-1235,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析贝伐珠单抗联合化疗对Ⅲb/Ⅳ期非鳞非小细胞肺癌(NSNSCLC)患者疾病控制率及血清T细胞亚群水平的影响。方法选取2015年1月~2017年2月我院收治的72例Ⅲb/Ⅳ期NSNSCLC患者,随机数字表法分为两组,各36例,对照组给予多西紫杉醇联合顺铂化疗,观察组给予贝伐珠单抗联合多西紫杉醇、顺铂治疗,比较两组治疗3个周期后客观有效率(ORR)、疾病控制率(DCR)、肿瘤标志物[细胞角蛋白19片段(CK-19)、肿瘤特异性生长因子(TSGF)、癌抗原50(CA50)、癌胚抗原(CEA)]水平、血清T细胞亚群(CD+3、CD+4、CD+8)水平、血管内皮生长因子(VEGF)信号通路[蛋白酶C(PKC)、丝裂原活化蛋白激酶(MAPK)、核因子kB(NF-kB)]mRNA表达、中位总生存期(mOS)、中位无进展生存期(mPFS)、毒副反应发生情况。结果观察组ORR、DCR(58.33%、86.11%)高于对照组(27.78%、61.11%)(P<0.05);观察组治疗3个周期后CK-19、TSGF、CA50、CEA低于对照组(P<0.05);观察组治疗后CD+3、CD+4与治疗前相比无显著差异(P>0.05),但高于对照组(P<0.05);观察组治疗3个周期后PKC、MAPK、NF-kB mRNA低于对照组(P<0.05);观察组mPFS、mOS长于对照组(P<0.05);两组胃肠道反应、粒细胞降低、血小板减少、贫血、白细胞下降毒副反应发生率比较无显著差异(P>0.05)。结论贝伐珠单抗联合化疗应用于Ⅲb/Ⅳ期NSNSCLC,可有效控制患者病情,延长患者mPFS、mOS,疗效显著,且能减小化疗对机体免疫功能影响,安全性较高,其机制可能与抑制PKC、MAPK、NF-kB通路有关。Objective To analyze the effect of bevacizumab combined with chemotherapy on disease control rate and serum T cell subsets in patients with stage Ⅲb/Ⅳ non-squamous non-small cell lung cancer(NSNSCLC). Methods 72 patients with stage Ⅲb/Ⅳ NSNSCLC admitted to our hospital from January 2015 to February 2017 were randomly divided into two groups, with 36 cases in each group. The control group was given docetaxel plus cisplatin chemotherapy, and the observation group was given bevacizumab combined with docetaxel and cisplatin. The objective response rate(ORR), disease control rate(DCR), and tumor markers [cytokeratin 19 fragment(CK-19) were compared after 3 cycles of treatment between the two groups. Tumor specific growth factor(TSGF), cancer antigen 50(CA50), carcinoembryonic antigen(CEA) levels, serum T cell subsets(CD3^+, CD4^+, CD^8+) levels, vascular endothelial growth factor(VEGF) signaling pathway [Protease C(PKC), mitogen-activated protein kinase(MAPK), nuclear factor kB(NF-kB)] mRNA expression, median overall survival(mOS), median progression-free survival(mPFS), and toxic side effects were counted. Results ORR and DCR(58.33%, 86.11%) were higher in the observation group than in the control group(27.78%, 61.11%)(P<0.05). The CK-19, TSGF, CA50 and CEA in the observation group were lower than those in the control group after 3 cycles.(P<0.05). There was no significant difference between CD3^+ and CD4^+ in the observation group(P>0.05), but higher than that in the control group(P<0.05). PKC, MAPK and NF-kB mRNA were significantly lower in the observation group than in the control group after 3 cycles(P<0.05). mPFS and mOS in the observation group were longer than those in the control group(P<0.05). The incidence of gastrointestinal reactions, granulocytopenia, thrombocytopenia, anemia, and leukocyte decreased side effects in the two groups showed no significant difference( P > 0. 05). Conclusion The combination of bevacizumab and chemotherapy at stage Ⅲb/Ⅳ NSNSCLC can effectively control the patient�

关 键 词：疾病控制率 T细胞亚群 非小细胞肺癌 化疗 贝伐珠单抗 Ⅲb/Ⅳ期 

分 类 号：R734.2[医药卫生—肿瘤]