重组人血管内皮抑制素联合VP方案对晚期非小细胞肺癌患者外周血肿瘤标志物水平的影响

Effect of recombinant human endostafin combined with VP regimen on levels of tumor markers in peripheral blood of patients with advanced non small cell lung cancer

目的探讨重组人血管内皮抑制素（恩度）联合VP方案（顺铂和长春地辛）对晚期非小细胞肺癌患者外周血肿瘤标志物水平的影响。方法纳入84例晚期非小细胞肺癌患者，根据治疗方案不同随机分为对照组和治疗组，每组42例，对照组患者给予VP方案治疗，治疗组采用重组人血管内皮抑制素联合VP方案治疗，比较两组疗效、血管内皮因子（VEGF）、血清肿瘤标记物、不良反应。结果治疗组疾病控制率为73．81％，对照组为42．86％，两组比较差异有统计学意义（P〈0．01）；治疗后两组血管内皮生长因子、细胞角蛋白19片段、癌胚抗原和糖类抗原50水平均显著降低（P〈0．05），且治疗后治疗组下降幅度显著高于对照组，差异有统计学意义（P〈0．05）；两组白细胞减少、恶心呕吐、肝功能损伤、肾功能损伤、心脏毒性、脱发和乏力等不良反应比较差异未见统计学意义（P〉0．05）。结论重组人血管内皮抑制素联合VP方案可增强晚期非小细胞肺癌患者近期治疗效果，降低血清VEGF和肿瘤标记物水平，不良反应少，安全有效。

Objective To study the effect of recombinant human endostatin （Endostar） combined with VP regimen （cisplatin and vindesine） on levels of tumor markers in peripheral blood of patients with advanced non small cell lung cancer （NSCLC）. Methods Eight-four patients with advanced NSCLC admitted to our hospital were divided into control group and treatment group （with 42 cases in each group） according to different treatment plans. The patients in the control group were treated with VP regimen, while the patients in treatment group were treated with recombinant human endostatin combined with VP regimen. The curative effect, vascular endothelial growth factor （VEGF）, serum tumor markers and adverse reactions were compared between the two groups. Results The disease control rate in the treatment group was 73.81%, while that in the control group was 42. 86% （P 〈0. 01 ）. After treatment, the levels of VEGF, cytokeratin 19 fragment （CYFRA21-1）, carcinoembryonic antigen （CEA） and carbohydrate antigen 50 （CA50） were significantly decreased （P 〈0.05）, and the levels in treatment group were significantly lower than those in control group （P 〈 0. 05 ）. There were no significant differences in hypoleucocytosis, nausea or vomiting, liver function damage, renal function damage, cardiac toxicity, alopecia, fatigue or other side effects between the two groups （P 〉 0.05 ）. Conclusions Recombinant human endostatin combined with VP regimen can improve the short-term therapeutic effect on patients with advanced NSCLC, and reduce the levels of serum VEGF and tumor markers, with few side effects, is safe and effective.