阿帕替尼联合培美曲塞对一线靶向治疗失败后晚期肺腺癌患者血清血管内皮生长因子、基质金属蛋白酶-9水平及中位无进展生存期的影响

Effects of Apatinib Combined with Pemetrexed on Serum Vascular Endothelial Growth Factor and Matrix Metalloproteinase-9 Levels and Median Progression-free Survival in Patients with Advanced Lung Adenocarcinoma after Failure of First-line Targeted Therapy

目的:分析阿帕替尼联合培美曲塞对一线靶向治疗失败后晚期肺腺癌患者血清血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)水平及中位无进展生存期的影响。方法:选取2017年4月—2019年5月焦作煤业(集团)有限责任公司中央医院收治的98例一线靶向治疗失败后晚期肺腺癌患者,根据随机数表法分为观察组、对照组。对照组49例接受培美曲塞治疗,观察组49例接受阿帕替尼联合培美曲塞治疗,比较两组患者临床控制率、中位无进展生存期、治疗前后肿瘤标志物[血清癌胚抗原(CEA)、细胞角蛋白19的可溶性片段(CYFRA21-1)、糖类抗原125(CA125)]、血清VEGF、MMP-9水平、不良反应。结果:与对照组(51.02%)相比,观察组临床控制率(73.47%)较高,差异有统计学意义(χ^(2)=5.254,P<0.05),观察组中位无进展生存期时间较对照组长,差异有统计学意义(P<0.05),治疗后,两组患者肿瘤标志物水平均有所降低,且观察组血清CEA、CYFRA21-1、CA125水平均低于对照组,差异有统计学意义(t=18.198、44.038、17.723,P<0.05)。治疗后,与对照组对比,观察组血清VEGF、MMP-9水平均较低,差异有统计学意义(t=0.232、49.924、0.157、28.721,P<0.05)。两组患者不良反应发生率对比,差异无统计学意义(χ^(2)=0.049、0.446,P>0.05)。结论:一线靶向治疗失败后晚期肺腺癌患者接受阿帕替尼联合培美曲塞治疗,效果显著,能有效控制患者病情进展,降低肿瘤标志物水平,延长生存时间,调节血清VEGF、MMP-9水平,且安全性高。

Objective:To analyze the effect of apatinib combined with pemetrexed on serum vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9)levels and median progression-free survival in patients with advanced lung adenocarcinoma after failure of first-line targeted therapy.influence.Methods:A total of 98 patients with advanced lung adenocarcinoma after failure of first-line targeted therapy in the hospital(April 2017 to May 2019)were selected and divided into observation group and control group according to the random number table method.The control group(49 cases)received pemetrexed treatment,and the observation group(49 cases)received apatinib combined with pemetrexed treatment.The clinical control rate,median progression-free survival,tumor markers before and after treatment[serum carcinoembryonic antigen(CEA),soluble fragment of cytokeratin 19(CYFRA21-1),carbohydrate antigen 125(CA125)],serum VEGF,MMP-9 levels,and adverse reactions were compared between the two groups.Results:Compared with the control group(51.02%),the clinical control rate of the observation group(73.47%)was higher,and the difference was statistically significant(χ^(2)=5.254,P<0.05).The median progression-free survival time of the observation group was longer than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of tumor markers in the two groups were decreased,and the serum levels of CEA,CYFRA21-1,and CA125 in the observation group were lower than those in the control group,and the difference was statistically significant(t=18.198,44.038,17.723,P<0.05).After treatment,compared with the control group,the serum levels of VEGF and MMP-9 in the observation group were lower,and the difference was statistically significant(t=0.232,49.924,0.157,28.721,P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.049,0.446,P>0.05).Conclusion:Apatinib combined with pemetrexed in patients with advanced lung adenocarcinoma after failure of first-line targeted therapy has a significant effect,which can effectively control the progression of the patients’disease,reduce the level of tumor markers,prolong survival time,and regulate serum VEGF,MMP-9 level and high safety.