重组人血管内皮抑制素治疗晚期NSCLC的疗效及对患者血清肿瘤标志物水平和血管新生的影响

Effect of Recombinant Human Endostatin in the Treatment of Advanced NSCLC and its Influence on Serum Level of Tumor Markers and Angiogenesis

探讨重组人血管内皮抑制素注射液治疗晚期非小细胞肺癌(NSCLC)的疗效及对患者血清肿瘤标志物水平和血管新生的影响。依据随机数字表法分配原则将2020年1月至2021年6月医院收治的86例晚期NSCLC患者分为对照组(43例)和治疗组(43例)。对照组给予注射用盐酸吉西他滨+注射用顺铂进行治疗,治疗组在对照组基础上给予重组人血管内皮抑制素注射液进行治疗,两组均以14 d为1个周期,连续治疗1个周期。比较两组治疗1个周期后的疗效,治疗前、治疗1个周期后的肺功能指标、血清肿瘤标志物、血管新生指标、生活质量及治疗期间的安全性。与对照组客观缓解率(ORR)(46.51%)比较,治疗组治疗1个周期后的ORR较高(72.09%,P<0.05)。与治疗前比较,治疗1个周期后,两组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流速(PEF)及生活质量调查表肺癌13(QLQ-LC13)评分均升高,治疗组高于对照组(P<0.05);两组血清人细胞角蛋白21-1片段(CYFRA21-1)、胸苷激酶-1(TK-1)、鳞状上皮细胞癌抗原(SCC-Ag)、糖类抗原125(CA125)、癌胚抗原(CEA)、低氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)及外周血活性循环内皮细胞(aCECs)、循环内皮细胞(CECs)水平均降低,治疗组低于对照组(P<0.05)。对照组和治疗组治疗期间的不良反应总发生率比较,差异无统计学意义(18.60%vs 13.95%,P>0.05)。重组人血管内皮抑制素注射液可有效调节晚期NSCLC患者肺功能、血管新生指标及血清肿瘤标志物水平,改善肺功能,抑制血管新生,控制肿瘤进展,进而可提高患者生活质量及疗效,且具有良好的安全性。

To investigate the effect of recombinant human endostatin injection in the treatment of advanced non-small cell lung cancer(NSCLC)and its influence on serum level of tumor markers and angiogenesis,86 patients with advanced NSCLC admitted to the authour's hospital from January 2020 to June 2021 were divided into the control group(43 cases)and the treatment group(43 cases)according to the distribution principle of random number table.The control group was treated with gemcitabine hydrochloride for injec-tion+cisplatin for injection,and the treatment group was treated with recombinant human endostatin injection on the basis of the con-trol group.Both groups took 14 d as a cycle and continued treatment for 1 cycle.The curative effect after 1 cycle of treatment,pulmo-nary function index,serum level of tumor marker,angiogenesis index,quality of life and safety during treatment were compared between the two groups.Compared with the objective response rate(ORR)of the control group(46.51%),the treatment group had a higher ORR after 1 cycle of treatment(72.09%,P<0.05).Compared with that before treatment,after 1 cycle of treatment,the forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximum expiratory flow rate(PEF)and score of the quality of life questionnaire-lung cancer 13(QLQ-LC13)of the two groups increased,and those in the treatment group were higher than those in the control group(P<0.05);the serum levels of human cytokeratin 21-1 fragment(CYFRA21-1),thymidine kinase 1(TK-1),squamous cell carcinoma antigen(SCC-Ag),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),hypoxia inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),and the peripheral blood levels of circulating endothelial cells(aCECs),circulating endothelial cells(CECs)of the two groups decreased,and those in the treatment group were lower than those in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the control group and the treatment group during treatment(18.60%vs 13.95%,P>0.05).Recombinant human endostatin injection could effectively regulate pulmonary function,angiogenesis indexes and serum level of tumor marker in patients with advanced NSCLC,improve pulmonary function,inhibit angiogenesis,control tumor progression,and further improve the quality of life and efficacy of patients,with higher safety.