腹腔灌注贝伐珠单抗联合紫杉醇和铂类化疗对Ⅲb~Ⅳ期卵巢癌患者血清肝细胞生长因子和巨噬细胞移动抑制因子水平的影响  

Effect of intraperitoneal perfusion of bevacizumab combined with paclitaxel and platinum chemotherapy on serum hepatocyte growth factor and macrophage migration inhibitory factor in patients with stage Ⅲb-Ⅳ ovarian cancer

作　　者：王立[1] 姜忠于 胡春秀[1] 刘学武[1] 谢高禹 WANG Li;JIANG Zhong-Yu;HU Chun-Xiu(Department of Oncology,Zhejiang Quhua Hospital,Quhua,Zhejiang 324004,China)

机构地区：[1]浙江衢化医院肿瘤内科,浙江衢化324004 [2]舟山医院肿瘤内科,浙江舟山316000

出　　处：《中国妇幼保健》2022年第15期2864-2868,共5页Maternal and Child Health Care of China

基　　金：浙江省医学科技攻关计划项目(LGF19H150078)。

摘　　要：目的 分析腹腔灌注贝伐珠单抗联合紫杉醇和铂类化疗对Ⅲb~Ⅳ期卵巢癌患者血清肝细胞生长因子(HGF)和巨噬细胞移动抑制因子(MIF)水平的影响,为卵巢癌患者的治疗提供参考依据。方法 选取2019年1—12月浙江衢化医院收治的80例Ⅲb~Ⅳ期卵巢癌患者,采用随机数字表分为观察组和对照组,每组40例患者。两组均行卵巢肿瘤细胞减灭手术,对照组术后采用紫杉醇、顺铂静脉化疗,观察组在对照组基础上增加贝伐珠单抗腹腔灌注。比较两组临床疗效和毒副反应,治疗前和治疗9周后评估两组血清肿瘤标志物水平[癌抗原125(CA125)、MIF及人附睾蛋白4(HE4)]、肿瘤细胞因子[HGF、血管内皮生长因子(VEGF)及碱性成纤维因子(bFGF)]及免疫功能指标(CD3^(+)T淋巴细胞亚群、CD4^(+)T淋巴细胞亚群、CD4^(+)/CD8^(+)T淋巴细胞亚群比值),随访患者1年生存率。结果 80例患者均完成治疗。观察组治疗总有效率(77.50%)显著高于对照组(52.50%),差异有统计学意义(χ^(2)=5.495,P=0.019)。观察组骨髓抑制、恶心呕吐、腹泻、肝损害及肾损害发生率(0~Ⅰ度:67.50%、80.00%、80.00%、95.00%、97.50%;Ⅱ~Ⅳ度:32.50%、20.00%、20.00%、5.00%、2.50%)与对照组(0~Ⅰ度:72.50%、87.50%、90.00%、97.50%、100.00%;Ⅱ~Ⅳ度:27.50%、12.50%、10.00%、2.50%、0.00%)比较,差异均无统计学意义(χ^(2)=0.238,0.827,1.569,0.346,0.000,均P>0.05)。治疗9周后,两组血清CA125、MIF、HE4、HGF、VEGF及bFGF水平均低于治疗前[观察组:(92.95±11.09)U/ml、(14.84±3.15)ng/ml、(645.89±62.26)pmol/L、(12.36±1.60)ng/ml、(59.71±9.06)ng/ml、(121.58±29.72)ng/L;对照组:(94.20±10.29)U/ml、(14.77±3.70)ng/ml、(639.67±69.92)pmol/L、(12.98±1.68)ng/ml、(57.83±11.28)ng/ml、(124.58±27.15)ng/L],差异均有统计学意义(均P<0.05),观察组治疗后血清CA125、MIF、HE4、HGF、VEGF及bFGF水平[(27.62±7.52)U/ml、(4.34±1.70)ng/ml、(232.33±45.06)pmol/L、(6.35±1.24)ng/ml、(21.84±5.Objective To analyze the effect of intraperitoneal perfusion of bevacizumab combined with paclitaxel and platinum chemotherapy on serum hepatocyte growth factor(HGF) and macrophage migration inhibition factor(MIF) in patients with stage Ⅲb-Ⅳ ovarian cancer, provide a reference basis for treatment of ovarian cancer.Methods From January to December in 2019, 80 patients with stage Ⅲb-Ⅳ ovarian cancer were selected from Zhejiang Quhua Hospital and divided into observation group and control group according to random number table, 40 cases in each group. The patients in the two groups underwent ovarian tumor cytoreductive surgery, the patients in control group underwent intravenous chemotherapy combined with paclitaxel and cisplatin after operation, while the patients in observation group underwent intraperitoneal perfusion of bevacizumab on the basis of intravenous chemotherapy with paclitaxel and cisplatin after operation.The clinical effects and toxic and adverse effects in the two groups were compared.Before treatment and at nine weeks after treatment, the levels of serum tumor markers [cancer antigen 125(CA125), MIF, and human epididymal protein 4(HE4)], tumor cytokines [HGF, vascular endothelial growth factor(VEGF), and basic fibroblast factor(bFGF)], and immune function indexes(CD3T lymphocyte subgroup, CD4T lymphocyte subgroup, and CD4/CD8T lymphocyte subgroup ratio).The one-year survival rates of patients in the two groups were followed up.Results Treatment was completed in the 80 patients.The total effective rate in observation group(77.50%) was statistically significantly higher than that in control group(52.50%)(χ^(2)=5.495, P=0.019).There was no statistically significant difference in the incidence rates of bone marrow suppression, nausea and vomiting, diarrhea, liver damage and kidney damage between observation group(degree 0-Ⅰ: 67.50%, 80.00%, 80.00%, 95.00%, 97.50%;degree Ⅱ-Ⅳ: 32.50%, 20.00%, 20.00%, 5.00%, 2.50%) and control group(degree 0-Ⅰ: 72.50%, 87.50%, 90.00%, 97.50%, 100.00%;deg

关 键 词：晚期卵巢癌 腹腔灌注 贝伐珠单抗 肝细胞生长因子 巨噬细胞移动抑制因子 

分 类 号：R737.31[医药卫生—肿瘤]