阿帕替尼联合多西他赛对晚期NSCLC患者血清肿瘤标记物水平及预后的影响

Effect of Apatinib Combined with Docetaxel on Serum Tumor Marker Levels and Prognosis in Patients with Advanced NSCLC

目的:探讨晚期非小细胞肺癌(NSCLC)患者应用阿帕替尼联合多西他赛治疗的效果。方法:回顾性分析郑州市第三人民医院2017年1月至2019年1月收治的64例晚期NSCLC患者,按照治疗方式不同分为对照组与观察组,各32例,对照组予以多西他赛治疗,观察组加用阿帕替尼治疗,均连续治疗12周。对两组近期疗效、血清肿瘤标记物水平、免疫功能指标、基质金属蛋白酶(MMP-9)水平、血管内皮生长因子(VEGF)水平、预后情况及药物副作用进行对比。结果:治疗后,观察组客观缓解率高于对照组,鳞状上皮细胞癌抗原、癌胚抗原、糖蛋白抗原125、细胞角蛋白19片段抗原21-1、MMP-9、VEGF水平均低于对照组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05);对照组中位无进展生存时间(PFS)为13个月,中位总生存时间(OS)为29个月,观察组中位PFS为19个月,中位OS为43个月,两组比较,差异显著(P<0.05);两组毒副作用发生率比较,无显著性差异(P>0.05)。结论:晚期NSCLC患者应用阿帕替尼联合多西他赛治疗可降低血清肿瘤标志物水平,改善免疫功能,延长患者生存时间,且短期内不会增加不良反应,具有较高的临床应用价值。

Objective:To investigate the effect of Apatinib combined with docetaxel in patients with advanced non-small cell lung cancer(NSCLC).Methods:64 patients with advanced NSCLC admitted to the Third People's Hospital of Zhengzhou from January 2017 to January 2019 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,32 cases in each group.The control group was treated with docetaxel,the observation group was treated with apatinib,all patients were treated continuously for 12 weeks.The short-term efficacy,serum tumor marker levels,immune function indexes,matrix metalloproteinase(MMP-9)levels,vascular endothelial growth factor(VEGF)levels,prognosis and drug side effects were compared between the two groups.Results:After treatment,the objective remission rate of the observation group was higher than that of the control group,while the levels of squamous cell carcinoma antigen,carcinoembryonic antigen,glycoprotein antigen 125,cytokeratin 19 fragment antigen 21-1,MMP-9 and VEGF were lower than those of the control group.CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05).The median progression-free survival(PFS)of the control group was 13 months.Median overall survival time(OS)was 29 months,The median PFS and OS of the observation group were 19 months and 43 months respectively.The difference between the two groups was significant(P<0.05).There was no significant difference in the incidence of toxicity and side effects between the two groups(P>0.05).Conclusion:Apatinib combined with docetaxel reduces serum tumor marker levels in patients with advanced NSCLC.It can improve the immune function and prolong the survival time of patients without increasing adverse reactions in the short term,which has high clinical application value.