贝伐珠单抗对晚期结直肠癌血清D-二聚体和纤维蛋白原水平及动静脉血栓栓塞形成的影响  

Impacts of bevacizumab on D-dimer,fibrinogen and arteriovenous thromboembolism in the treatment of advanced colorectal cancer

作　　者：缪敏[1] 瞿凯泉 周娟 丁倩 MIAO Min;QU Kaiquan;ZHOU Juan;DING Qian(Department of Oncology,Yangzhou Jiangdu People's Hospital,Yangzhou,Jiangsu 225200,China;不详)

机构地区：[1]扬州市江都人民医院肿瘤科,江苏扬州225200 [2]启东市人民医院南通大学附属启东医院,江苏南通226200

出　　处：《中国临床研究》2023年第9期1328-1332,共5页Chinese Journal of Clinical Research

基　　金：扬州市科技计划项目(YZ2020117)。

摘　　要：目的分析晚期结直肠癌治疗中贝伐珠单抗对患者D-二聚体(D-D)、纤维蛋白原(FIB)及动静脉血栓栓塞形成的影响。方法回顾性分析江都人民医院2017年1月至2021年12月收治的96例晚期结直肠癌患者的临床资料。给予XELOX方案(卡培他滨+奥沙利铂)化疗的48例设为对照组,在对照组基础上加贝伐珠单抗治疗的48例设为观察组,比较两组客观缓解率(ORR)、疾病控制率(DCR)、血清肿瘤标志物、D-D、FIB及动静脉血栓栓塞发生率、毒副反应总发生率。结果与对照组比较,观察组ORR(52.08%vs 29.17%)、DCR(83.33%vs 56.25%)均增高(P<0.05)。观察组治疗1、3、6周期血清糖类抗原199(CA199)、癌胚抗原(CEA)均低于对照组(P<0.05);治疗1、3周期血清D-D、FIB与对照组相当(P>0.05),治疗6周期血清D-D、FIB均高于对照组(P<0.05)。观察组动静脉血栓栓塞发生率与对照组比较差异无统计学意义(8.33%vs 0,P>0.05);两组毒副反应发生情况差异亦无统计学意义(P>0.05)。结论在常规化疗基础上加用贝伐珠单抗治疗晚期结直肠癌,可有效提高疾病ORR和DCR,降低患者血清肿瘤标志物水平,毒副反应较轻;贝伐珠单抗治疗初期血清D-D、FIB水平变化不大,但随着治疗周期的延长有增高趋势,容易引起动静脉血栓栓塞。Objective To analyze the effect of bevacizumab on D-dimer(D-D),fibrinogen(FIB)and arteriovenous thromboembolism in the treatment of advanced colorectal cancer(aCRC).Methods A retrospective analysis was performed on the clinical data of 96 patients with aCRC treated in Jiangdu People s Hospital from January 2017 to December 2021.The patients were divided into control group[received XELOX regimen(capecitabine and oxaliplatin),n=48]and observation group(received bevacizumab treatment on the basis of XELOX regimen,n=48).The objective response rate(ORR),disease control rate(DCR),levels of serum tumor markers,serum D-D and FIB,the incidence of arteriovenous thromboembolism and the total incidence of toxic and side effects were compared between two groups.Results Compared with control group,ORR(52.08%vs 29.17%)and DCR(83.33%vs 56.25%)were significantly increased in observation group(P<0.05).Serum levels of carbohydrate antigen 199(CA199)and carcinoembryonic antigen(CEA)in observation group were statistically lower than those in control group after 1,3 and 6 cycles of chemotherapy(P<0.05).After 1 and 3 cycles of chemotherapy,serum D-D and FIB were similar in two groups(P>0.05),and they were significantly higher in observation group than those in control group after 6 cycles of treatment(P<0.05).There was no significant difference in the incidences of arteriovenous thromboembolism(8.33%vs 0,P>0.05)and toxic side effects between observation group and control group(P>0.05).Conclusion On the basis of conventional chemotherapy for advanced colorectal cancer,the addition of bevacizumab can effectively improve the ORR and DCR of CRC patients,reduce the serum levels of tumor markers and have little impact on serum D-D and FIB levels at the beginning of chemotherapy.

关 键 词：晚期结直肠癌 贝伐珠单抗 卡培他滨 奥沙利铂 D-二聚体 纤维蛋白原 动静脉血栓栓塞 

分 类 号：R735.3[医药卫生—肿瘤]