阿帕替尼辅助治疗晚期肺癌相关恶性胸腔积液患者的效果

Effect of Apatinib in Adjuvant Treatment of Patients with Advanced Lung Cancer-Related Malignant Pleural Effusion

目的分析阿帕替尼辅助治疗晚期肺癌相关恶性胸腔积液(MPE)患者的效果。方法回顾性选取2016年9月至2019年9月睢县人民医院收治的68例晚期肺癌相关MPE患者作为研究对象,将接受吉西他滨联合顺铂(GP)方案化疗的32例作为对照组,将接受阿帕替尼联合GP方案化疗的36例作为观察组。比较两组治疗效果(疾病控制率、总有效率)、治疗前后肿瘤标志物[血清鳞状细胞癌抗原(SCCA)、细胞角蛋白19片段(CYERA21-1)、癌胚抗原(CEA)]水平、免疫功能[T淋巴细胞CD3^(+)亚群(CD3^(+))、T淋巴细胞CD4^(+)亚群(CD4^(+))、T淋巴细胞CD8^(+)亚群(CD8^(+))]、毒副反应发生情况(骨髓抑制、恶心、呕吐、肝肾功能损害、皮疹等)和效益情况(治疗花费、效价比)。结果与对照组对比,观察组疾病控制率、总有效率均较高(P<0.05);治疗后,两组血清肿瘤标志物水平均有所降低,且观察组血清CYERA21-1、SCCA、CEA均低于对照组(P<0.05);治疗后,两组免疫功能均得到提升,且观察组CD3^(+)、CD4^(+)较对照组高,CD8^(+)较对照组低(P<0.05);两组骨髓抑制、恶心、呕吐、肝肾功能损害、皮疹发生率对比,差异无统计学意义(P>0.05);与对照组对比,观察组治疗花费、效价比均较高(P<0.05)。结论阿帕替尼联合GP方案化疗对晚期肺癌相关MPE患者的效果显著,能有效降低肿瘤标志物水平,改善免疫功能,且不会增加毒副反应,但会增加治疗相关费用。

Objective To analyze the effect of apatinib in adjuvant treatment of patients with advanced lung cancer-related malignant pleural effusion(MPE).Methods A retrospective selection of 68 patients with advanced lung cancer-related MPE admitted to Suixian People’s Hospital from September 2016 to September 2019 were selected as the research subjects,and 32 patients who received gemcitabine and cisplatin(GP)chemotherapy treatment as a control group,36 patients who received apatinib combined with GP chemotherapy as the observation group.The two groups’treatment effects(disease control rate,total effective rate),levels of tumor markers[serum squamous cell carcinoma antigen(SCCA),cytokeratin 19 fragment(CYERA21-1),carcinoembryonic antigen(CEA)]before and after treatment,immune function[T lymphocyte CD3^(+)subgroup(CD3^(+)),T lymphocyte CD4^(+)subgroup(CD4^(+)),T lymphocyte CD8^(+)subgroup(CD8^(+))],the occurrence of toxic and side effects(bone marrow suppression,nausea and vomiting,liver and kidney function damage,rash,etc.),and benefits(treatment cost,potency ratio)were compared.Results Compared with the control group,the observation group had higher disease control rate and total effective rate(P<0.05).After treatment,the serum tumor marker levels of the two groups decreased,and the observation group’s serum CYERA21-1,SCCA,CEA were lower than the control group(P<0.05).After treatment,the immune function of the two groups was improved,and the observation group had higher CD3^(+)and CD4^(+)than the control group,and lower CD8^(+)than the control group(P<0.05).There was no difference in bone marrow suppression,nausea,vomiting,liver and kidney damage,and skin rash in the two groups(P>0.05).Compared with the control group,the treatment cost and titer ratio of the observation group were higher(P<0.05).Conclusion Patients with advanced lung cancer-related MPE receiving apatinib combined with GP chemotherapy have a significant effect,which can effectively reduce the level of tumor markers,improve immune function,and will not increase toxic and side effects,but will increase treatment-related costs.