深部热疗联合重组人血管内皮抑制素注射液及AP方案治疗晚期非小细胞肺癌效果观察  

Efficacy observation of deep hyperthermia combined with recombinant human vascular endothelial inhibitor injection and AP regimen in treatment of advanced non⁃small cell lung cancer

作　　者：李超 肖敬 周红梅[2] Li Chao;Xiao Jing;Zhou Hongmei(Department of Oncology,the Seventh People's Hospital of Hebei Province,Dingzhou 073099,China;Department of Pulmonary Disease,the Seventh People's Hospital of Hebei Province,Dingzhou 073099,China)

机构地区：[1]河北省第七人民医院肿瘤科,定州073099 [2]河北省第七人民医院肺病科,定州073099

出　　处：《肿瘤研究与临床》2022年第12期892-897,共6页Cancer Research and Clinic

基　　金：河北省医学科学研究课题(20211795)。

摘　　要：目的探讨深部热疗联合重组人血管内皮抑制素注射液及AP(培美曲塞+顺铂)方案治疗晚期非小细胞肺癌(NSCLC)的效果以及对患者血清肿瘤标志物水平、免疫功能的影响。方法采用前瞻性随机对照研究方法,纳入河北省第七人民医院2016年1月至2022年1月收治的106例晚期NSCLC患者,按随机数字表法平均分为两组,每组53例,对照组采用重组人血管内皮抑制素注射液联合AP方案治疗,观察组在对照组基础上加用深部热疗。连续治疗4个周期后观察两组近期疗效。采用化学发光法检测治疗前后血清癌胚抗原(CEA)、糖类抗原125(CA125)及细胞角蛋白片段19 CYFR21‑1水平;采用流式细胞术检测外周血T细胞亚群水平。比较两组不良反应发生情况。结果观察组和对照组客观缓解率分别为58.49%(31/53)、37.74%(20/53),疾病控制率分别为92.45%(49/53)、75.47%(40/53),观察组均高于对照组(χ^(2)=4.53,P=0.033;χ^(2)=5.62,P=0.018)。治疗前两组血清癌胚抗原(CEA)、糖类抗原125(CA125)及CYFR21‑1水平差异均无统计学意义(均P>0.05),治疗后两组均较治疗前降低(均P<0.05),且治疗后观察组均较治疗后对照组低(均P<0.05)。治疗前两组间及观察组治疗前后外周血CD3^(+)、CD4^(+)、CD8^(+)T细胞水平及CD4^(+)与CD8^(+)T细胞比值(CD4^(+)/CD8^(+))差异均无统计学意义(均P>0.05);对照组治疗后外周血CD3^(+)、CD4^(+)T细胞水平及CD4^(+)/CD8^(+)均较治疗前降低(均P<0.05),外周血CD8^(+)T细胞水平较治疗前升高(P<0.05);治疗后观察组CD3^(+)、CD4^(+)细胞水平和CD4^(+)/CD8^(+)均高于治疗后对照组,CD8^(+)T细胞水平低于治疗后对照组,差异均有统计学意义(均P<0.001)。两组治疗过程中均出现了不同程度的胃肠道反应、骨髓抑制、肝肾功能损害及心脏毒性,但两组间各不良反应发生率差异均无统计学意义(均P>0.05)。结论深部热疗联合重组人血管内皮抑制素注射液及AP方案治疗晚�Objective To investigate the efficacy of deep hyperthermia combined with recombinant human vascular endothelial inhibitor injection and AP(pemetrexed+cisplatin)regimen in the treatment of advanced non‑small cell lung cancer(NSCLC)and its effects on serum tumor marker levels and immune function of patients.Methods In this prospective randomized controlled study,106 patients with advanced NSCLC who were admitted to the Seventh People's Hospital of Hebei Province from January 2016 to January 2022 were included,and were divided into two groups according to the random number table method,with 53 cases in each group.The control group was treated with recombinant human vascular endothelial inhibitor injection combined with AP regimen.The observation group was given recombinant human vascular endothelial inhibitor injection combined with AP regimen and deep hyperthermia.After 4 consecutive cycles of treatment,the short‑term efficacy of the two groups was observed.Chemiluminescence assay was used to detect the serum levels of carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and cytokeratin fragment 19 CYFR21‑1 before and after treatment.T lymphocyte subsets in peripheral blood were detected by flow cytometry.The occurrence of adverse reactions was compared between the two groups.Results The objective response rates in observation group and control group were 58.49%(31/53)and 37.74%(20/53),the disease control rates in observation group and control group were 92.45%(49/53)and 75.47%(40/53),the observation group was higher than the control group(χ^(2)=4.53,P=0.033;χ^(2)=5.62,P=0.018).The differences in serum carcinoembryonic antigen(CEA),glycoantigen 125(CA125)and CYFR21‑1 levels between the two groups before treatment were not statistically significant(all P>0.05),they were lower in both groups after treatment than before treatment(all P<0.05),and they were lower in the observation group after treatment than in the control group after treatment(all P<0.05).The differences in peripheral blood CD3^(+),CD

关 键 词：癌 非小细胞肺 透热疗法 内皮抑素类 抗肿瘤联合化疗方案 肿瘤标记 生物学 免疫系统 

分 类 号：R734.2[医药卫生—肿瘤]