贝伐单抗相关性高血压对结直肠癌和非小细胞肺癌患者预后的影响研究

Impact of Bevacizumab-induced Hypertension on Prognosis of Colorectal Cancer Patients and Non-small Cell Lung Cancer Patients

目的探讨贝伐单抗相关性高血压对结直肠癌和非小细胞肺癌患者预后的影响。方法选取2010年3月—2016年3月于延安大学附属医院行贝伐单抗治疗的384例结直肠癌患者和384例非小细胞肺癌患者,其中结直肠癌患者采用贝伐单抗联合细胞毒性药物化疗,非小细胞肺癌患者采用贝伐单抗联合标准化疗方案治疗。记录所有患者高血压发生情况、高血压分级及处理方法、生存情况,结直肠癌和非小细胞肺癌患者贝伐单抗相关性高血压的影响因素分析采用多因素logistic回归分析。结果 768例患者出现贝伐单抗相关性高血压188例(24.5%),其中结直肠癌患者出现贝伐单抗相关性高血压108例(28.1%),非小细胞肺癌患者出现贝伐单抗相关性高血压80例(20.8%)。结直肠癌患者出现1级贝伐单抗相关性高血压48例(44.5%),2级贝伐单抗相关性高血压35例(32.4%),3级贝伐单抗相关性高血压25例(23.1%)。非小细胞肺癌患者出现1级贝伐单抗相关性高血压37例(46.3%),2级贝伐单抗相关性高血压26例(32.5%),3级贝伐单抗相关性高血压17例(21.2%)。绘制Kaplan-Meier生存曲线发现,结直肠癌患者中出现高血压者较未出现高血压者更具有生存优势,非小细胞肺癌患者中出现高血压者较未出现高血压者亦更具生存优势(P<0.05)。多因素logistic回归分析结果显示,贝伐单抗治疗时间〔OR=2.82,95%CI(1.49,7.85)〕是结直肠癌患者贝伐单抗相关性高血压的影响因素,贝伐单抗治疗周期〔OR=1.83,95%CI(1.12,2.97)〕是非小细胞肺癌患者贝伐单抗相关性高血压的影响因素(P<0.05)。结论贝伐单抗相关性高血压可延长结直肠癌和非小细胞肺癌患者总生存时间,可在一定程度上改善患者预后。

Objective To investigate the impact of bevacizumab - induced hypertension on prognosis of colorectal cancer patients and non - small cell lung cancer patients. Methods A total of 384 colorectal cancer patients and 384 non - small cell lung cancer patients treated with bevacizumab were selected in the Affiliated Hospital of YaM＇an University from March 2010 to March 2016, thereinto colorectal cancer patients received bevacizumab combined with cytotoxic drugs for chemotherapy, while non - small cell lung cancer patients received bevacizumab combined with standard chemotherapy. Incidence, grading and treatment of bevacizumab - inoluced hypertension, survival situation were recorded, and influencing factors of bevacizumab - inoluced hypertension were analyzed by multivariate logistic regression analysis. Results Of all the 768 patients, 188 cases occurred bevacizumab - induced hypertension （ accounting for 24. 5% ）, including 108 cases in colorectal cancer patients （accounting for 28.1% ） and 80 cases in non - small cell lung cancer patients （accounting for 20. 8% ）. Of the colorectal cancer patients, 48 cases occurred l - grade bevacizumab - induced hypertension （ accounting for 44. 5% ）, 35 cases occurred 2 - grade bevacizumab - induced hypertension （ accounting for 32.4% ）, 25 cases occurred 3 - grade bevacizumab - induced hypertension （ accounting for 23.1% ）. Of the non - small cell lung cancer patients, 37 cases occurred 1 - grade bevacizumab - induced hypertension （ accounting for 46. 3% ） , 26 cases occurred 2 - grade bevacizumab - induced hypertension （ accountingfor 32. 5% ） , 17 cases occurred 3 - grade bevacizumab - induced hypertension （ accounting for 21.2% ）. Kaplan - Meier survival curve showed that, colorectal cancer patients appeared bevacizumab - induced hypertension had better survival advantage than those patients did not appear bevacizumab - induced hypertension, non - small cell lung cancer patients appeared bevacizumab- induced hypertension had better survival advantage than those patients did not appear bevacizumab - induced hypertension, too （P 〈0.05）. Multivariate logistic regression analysis results showed that, treatment time of bevacizumab [ OR =2. 82, 95% CI （ 1.49, 7.85 ） ] was the influencing factor of bevacizumab - induced hypertension in colorectal cancer patients, treatment cycle of bevacizumab （ OR = 1.83, 95% CI （ 1.12, 2.97） ] was the influencing factors of bevacizumab - induced hypertension in non - small cell lung cancer patients （ P 〈 0.05 ）. Conclusion Bevacizumab - induced hypertension can lengthen the overall survival of colorectal cancer patients and non - small cell lung cancer patients, improve the prognosis to some extent. [