贝伐珠单抗加同步放化疗联合二甲双胍对非小细胞肺癌患者疗效、免疫功能及肿瘤相关蛋白的影响

Effects of bevacizumab combined with concurrent chemoradiotherapy and metformin on the clinical effectiveness,immune function and tumor associated protein of NSCLC patients

目的探讨贝伐珠单抗加同步放化疗联合二甲双胍对非小细胞肺癌(NSCLC)患者临床疗效及磷酸腺苷活化蛋白激酶(AMPK)、血管内皮生长因子(VEGF)及血清趋化素的影响。方法选取盘锦辽油宝石花医院2016年2月—2019年2月收治的120例NSCLC患者为研究对象,随机数字表法分为研究组和对照组各60例,对照组给予贝伐珠单抗加同步放化疗,研究组在对照组基础上联合二甲双胍治疗,比较2组患者临床疗效以及治疗前后血清AMPK、VEGF、血清趋化素、胰岛素样生长因子-1(IGF-1)和雷帕霉素靶蛋白(mTOR)水平及免疫功能。结果研究组临床治疗有效率、疾病控制率、生活质量均优于对照组(P<0.05);治疗后研究组AMPK升高以及VEGF、血清趋化素、IGF-1、mTOR降低程度均优于对照组(P<0.05);且研究组患者治疗后免疫细胞CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平上升以及CD8^(+)水平下降程度均优于对照组(P<0.05);2组患者不良反应差异无统计学意义(P>0.05);研究组患者总生存期(OS)、无进展生存期(DFS)均长于对照组(P<0.05)。结论贝伐珠单抗加同步放化疗联合二甲双胍治疗NSCLC可有效降低患者VEGF及血清趋化素表达水平,提高患者AMPK蛋白表达水平,临床疗效显著。

Objective To investigate the effects of bevacizumab combined with concurrent chemoradiotherapy and metformin on the clinical effectiveness,adenosine monophosphate activated protein kinase(AMPK),vascular endothelial growth factor(VEGF)and serum chemerin of patients with non-small cell lung cancer(NSCLC).Methods A total of 120 NSCLC patients who were admitted to Liaoyou Baoshihua Hospital from February 2016 to February 2019 were enrolled.According to the random number table method,they were divided into two groups(n=60):a research group and a control group.The control group was given bevacizumab combined with concurrent chemoradiotherapy,while the research group was treated with metformin on the basis of the control group.Their clinical effectiveness and the levels of serum AMPK,VEGF and chemerin before and after treatment were compared.Results The research group presented remarkable improvement in clinical effectiveness rate,disease control rate,and quality of life,compared with the control group(P<0.05).After treatment,the research group showed significant increases in AMPK and decreases in VEGF,chemerin,insulin-like growth factor 1(IGF-1),and mammalian target of rapamycin(mTOR),compared with the control group(P<0.05).The research group also produced obviously increased immune cells(CD3^(+),CD4^(+)and CD4^(+)/CD8^(+))and decreased CD8^(+)after treatment,compared with the control group(P<0.05).There were statistical differences in adverse reactions between the two groups(P>0.05).The overall survival(OS)and progression-free survival(DFS)were longer for the research group than those in the control group(P<0.05).Conclusions Bevacizumab combined with concurrent chemoradiotherapy and metformin can effectively reduce the levels of serum VEGF and chemerin,and improve AMPK protein expression in NSCLC patients.