纳武利尤单抗联合化疗治疗中晚期胃癌患者的疗效及其与血管内皮生长因子、肿瘤坏死因子-α水平的关系  

Therapeutic effect of nivolumab combined with chemotherapy on patients with advanced gastric cancer and its relationship with vascular endothelial growth factor and tumor necrosis factorαlevels

作　　者：屈福莲 张红蕊 洪亚珍 张燕 刘培杰 QU Fulian;ZHANG Hongrui;HONG Yazhen;ZHANG Yan;LIU Peijie(Department of Oncology,Kaifeng Central Hospital,Kaifeng 475000,He’nan,China)

机构地区：[1]开封市中心医院肿瘤科,河南开封4750000

出　　处：《癌症进展》2024年第22期2541-2544,共4页Oncology Progress

摘　　要：目的 探讨纳武利尤单抗联合化疗治疗中晚期胃癌患者的疗效及其与血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)水平的关系。方法 根据治疗方法的不同将110例中晚期胃癌患者分为对照组(n=58)和联合组(n=52),对照组患者采取化疗,联合组患者采取纳武利尤单抗联合化疗,比较两组患者的临床疗效和不良反应发生情况。根据临床疗效将联合组患者分为有效组(完全缓解、部分缓解、疾病稳定)和无效组(疾病进展),比较两组患者的血清VEGF、TNF-α水平。采用Point-biserial相关分析法分析联合组患者血清VEGF、TNF-α水平与疗效的相关性。结果 联合组患者的疾病控制率高于对照组,差异有统计学意义(P﹤0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P﹥0.05)。联合组52例患者中,治疗有效37例,治疗无效15例。无效组患者的血清VEGF、TNF-α水平均明显高于有效组,差异均有统计学意义(P﹤0.01)。Point-biserial相关分析结果显示,联合组患者血清VEGF、TNF-α水平与疗效均呈负相关(P﹤0.05)。结论 纳武利尤单抗联合化疗治疗中晚期胃癌患者可提高临床疗效,且具有一定的安全性,血清VEGF、TNF-α水平越高,患者治疗无效的可能性就越大。Objective To investigate the therapeutic effect of nivolumab combined with chemotherapy on patients with advanced gastric cancer and its relationship with vascular endothelial growth factor(VEGF)and tumor necrosis fac-tor-α(TNF-α)levels.Method According to different treatment methods,110 patients with advanced gastric cancer were divided into control group(n=58)and combination group(n=52).Patients in the control group received chemotherapy,and patients in the combination group received nivolumab combined with chemotherapy.The clinical efficacy and ad-verse reactions were compared between the two groups.According to the clinical efficacy,patients in the combination group were divided into effective group(complete response,partial response,stable disease)and ineffective group(pro-gressive disease),and the serum levels of VEGF and TNF-αwere compared between the two groups.Point-biserial corre-lation analysis was used to analyze the correlation between serum VEGF,TNF-αlevels and therapeutic effect in the com-bination group.Result The disease control rate of the combination group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Among 52 patients in the combination group,37 cases were effective and 15 cases were ineffective after treatment.The serum levels of VEGF and TNF-αin the ineffective group were significantly higher than those in the effective group,and the differences were statistically significant(P<0.01).Point-biserial correla-tion analysis results showed that serum VEGF and TNF-αlevels in the combination group were negatively correlated with the therapeutic effect(P<0.05).Conclusion Nivolumab combined with chemotherapy can improve clinical efficacy and has certain safety in the treatment of patients with advanced gastric cancer.The higher the levels of serum VEGF and TNF-α,the more likely the treatment will be ineffective.

关 键 词：中晚期胃癌 纳武利尤单抗 血管内皮生长因子 肿瘤坏死因子-Α 

分 类 号：R735.2[医药卫生—肿瘤]