治疗前炎症指标及营养状态在接受贝伐珠单抗治疗的结直肠癌患者疗效评估中的作用  

The Role of Baseline Status of Inflammation and Nutrition in the Prediction for the Therapeutic Effects of Bevacizumab in Patients with Colorectal Cancer

作　　者：杨千洪 李峰 郑款恒 雷新键 YANG Qianhong;LI Feng;ZHENG Kuanheng;LEI Xinjian(Department of Gastrointestinal Surgery,the Afiliated Ningde Hospital of Ningde Normal University,Ningde 352100,China)

机构地区：[1]宁德师范学院附属宁德市医院胃肠外科,福建宁德352100

出　　处：《药物生物技术》2024年第6期664-667,共4页Pharmaceutical Biotechnology

摘　　要：观察接受贝伐珠单抗治疗的结直肠患者治疗前炎症水平及营养状态对疗效的影响。76例确诊为结直肠癌的患者,均接受贝伐珠单抗治疗,治疗前收集患者白细胞、纤维蛋白原和超敏C反应蛋白等炎症因子水平,并应用NRS-2002量表评估营养状况,观察治疗前患者炎症水平及营养状态对贝伐珠单抗治疗疗效的影响。纳入患者的中位治疗持续时间为(5.8±2.3)个月,无进展生存期为(8.9±2.8)个月,严重不良事件发生率为48.7%。相关性分析显示,治疗前患者超敏C反应蛋白水平与治疗持续时间(r=-0.324,P=0.021)及无进展生存期(r=-0.192,P=0.018)均呈负相关。与营养状态正常的患者相比,营养不良患者具有更短的治疗持续时间(P=0.009)及无进展生存期(P=0.012)。多因素回归分析显示,高超敏C反应蛋白水平及营养不良与接受贝伐珠单抗治疗后严重不良事件的发生密切相关(P<0.05)。对于治疗前存在超敏C反应蛋白水平升高和营养不良的患者,应用贝伐珠单抗治疗结直肠患者需严密监测和预防不良事件的发生。To investigate the role of baseline levels of inflammatory index and nutritional status in the prediction for the therapeutic effects of bevacizumab in patients with colorectal cancer,a total of 76 patients with colorectal cancer who received bevacizumab treatment were enrolled.Baseline blood levels of white blood cells,fibrinogen,and high sensitive C-reactive protein were examined.The nutritional status was assessed by using the questionnaire Nutritional Risk Screening 2002(NRS-2002).Treatment duration,progression free survival(PFS)and safety were recorded.Median treatment duration was 5.8±2.3 months and median PFS was 8.9±2.8 months.A total of 48.7%of patients experienced severe adverse events.Spearman correlation analysis showed that the levels of high sensitive C-reactive protein were negatively correlated with treatment duration time(r=-0.324,P=0.021)and PFS(r=-0.192,P=0.018).Moreover,the treatment duration time(P=0.009)and PFS(P=0.012)were shorter in patients with malnutrition when compared to those with normal nutritional status.Multivariate logistic analysis showed that high baseline levels of sensitive C-reactive protein and malnutrition was significantly correlated with the severe adverse events of bevacizumab treatment(P<0.05).Patients with high baseline level of sensitive C-reactive protein and malnutrition had higher risk of severe adverse events and should therefore be treated with caution.

关 键 词：贝伐珠单抗 结直肠癌 炎症水平 营养状态 治疗持续时间 无进展生存期 严重不良事件 

分 类 号：R735.34[医药卫生—肿瘤]