贝伐珠单抗胸腔灌注治疗恶性胸腔积液患者的效果及对血清VEGF、CEA、Cyfra21-1的影响

Effect of Bevacizumab Intrapleural Perfusion on Patients with Malignant Pleural Effusion and Its Effect on Serum VEGF,CEA and Cyfra21-1

目的:观察贝伐珠单抗胸腔灌注治疗恶性胸腔积液(MPE)患者的效果及对血清血管内皮生长因子(VEGF)、癌胚抗原(CEA)、细胞角蛋白19片段抗原21(Cyfra21-1)的影响。方法:回顾性分析东莞康华医院2018年11月-2021年11月收治的242例MPE患者的病历资料,根据治疗方法不同分为观察组(n=133)和对照组(n=109)。对照组接受培美曲塞+顺铂基础抗癌药物治疗,观察组在对照组基础上采用贝伐珠单抗胸腔灌注治疗。比较治疗前后两组的血清VEGF、CEA、Cyfra21-1水平变化,以及近期疗效和用药安全性。结果:观察组的客观缓解率高于对照组(P<0.05)。治疗前,两组血清VEGF、CEA、Cyfra21-1水平比较,差异无统计学意义(P>0.05);治疗后,两组血清VEGF、CEA、Cyfra21-1水平均较治疗前明显降低,且观察组水平均低于对照组(P<0.05)。两组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:应用贝伐珠单抗胸腔灌注治疗MPE患者可获得较好的近期效果,可降低其血清VEGF、CEA和Cyfra21-1水平,且用药安全性较好。

Objective:To observe the effect of Bevacizumab intrapleural perfusion on patients with malignant pleural effusion (MPE) and its effect on serum vascular endothelial growth factor (VEGF),carcinoembryonic antigen (CEA) and cytokeratin 19 fragment antigen 21 (Cyfra21-1).Method:Retrospective analysis was made on the medical records of 242 MPE patients admitted to Dongguan Kanghua Hospital from November 2018 to November 2021.According to different treatment methods,they were divided into observation group (n=133) and control group (n=109).The control group was treated with Pemetrexed and Cisplatin.The observation group was treated with Bevacizumab intrapleural perfusion on the basis of the control group.The changes of serum VEGF,CEA and Cyfra21-1 levels before and after treatment,as well as the short-term efficacy and drug safety were compared between the two groups.Result:The objective remission rate in the observation group was higher than that in the control group (P<0.05).There were no significant differences in the levels of serum VEGF,CEA and Cyfra21-1 between the two groups before treatment (P>0.05).After treatment,the levels of serum VEGF,CEA and Cyfra21-1 in the two groups were lower than those before treatment,and the levels of serum VEGF,CEA and Cyfra21-1 in the observation group were lower than those in the control group (P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05).Conclusion:Using Bevacizumab intrapleural perfusion to treat MPE patients can obtain good short-term effect,reduce the levels of serum VEGF,CEA and CYFRA21-1,and has good drug safety.