EXPRESSION OF VASCULAR ENDOTHELIAL GROWTH FACTOR AND BASIC FIBROBLAST GROWTH FACTOR IN HUMAN NON-SMALL CELL LUNG CANCER AND THEIR CLINICAL SIGNIFICANCE

Objective: To explore the expression of vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) in non-small cell lung cancer(NSCLC) and theIR clinical significance. Methods: The expression of VEGF and bFGF was examined at the protein levels by immunohistochemical staining in 96 NSCLC patients, and in 36 of which at the mRNA levels by reverse transcription-PCR analysis. Results: VEGF mRNAs were expressed predominately as its secretory forms (VEGF121 and VEGF165) in NSCLC tissues. The positive ratios of VEGF121 and VEGF165 were 69.5%(25 of 36) and 41.7%(15 of 36) respectively. The positive ratio of bFGF was 52.8(19 of 36) in the same tumor specimens. The positive ratios of VEGF and bFGF at protein levels were 55.55%(20 of 36) and 58.33%(21 of 36) respectively. A significant positive correlation was observed between VEGF and bFGF expression in NSCLC tissues(P=0.002). No significant interrelationship between VEGF, bFGF expression and clinical data(age, sex, histological subtype differentiation, P-stage, metastasis and survival) was found. Conclusions: VEGF and bFGF may play an important role in angiogenesis and act in a synergistic manner in NSCLC.

Expression of Nerve Growth Factor and Hypoxia Inducible Factor-1α and Its Correlation with Angiogenesis in Non-Small Cell Lung Cancer

Summary： In order to investigate the expression of nerve growth factor （NGF） and hypoxia inducible factor-1α （HIF-1α） and its correlation with angiogenesis in non-small cell lung cancer （NSCLC）, paraffin-embedded tissue blocks from 20 patients with NSCLC were examined. Twenty corresponding para-cancerous lung tissue specimens were obtained to serve as a control. The expression of NGF, HIF-1α, and vascular endothelial growth factor （VEGF） in the NSCLC tissues was detected by using immunohistochemistry. The microvascular density （MVD） was determined by CD31 staining. The resuits showed that the expression levels ofNGF, HIF-1α and VEGF in the NSCLC tissues were remarkably higher than those in the para-cancerous lung tissues （P〈0.05）. There was significant difference in the MVD between the NSCLC tissues （9.19±1.43） and para-cancerous lung tissues （2.23±1.19） （P〈0.05）. There were positive correlations between NGF and VEGF, between HIF-1α and VEGF, and between NGF and HIF-1α in NSCLC tissues, with the spearman correlation coefficient being 0.588, 0.519 and 0.588, respectively. In NSCLC tissues, the MVD had a positive correlation with the three factors （P〈0.05）. Theses results suggest that NGF and HIF-1α are synergically involved in the angiogenesis of NSCLC.

Clinical Significance of VEGF-C and VEGFR-3 Expression in Non-small Cell Lung Cancer

The relationship between vascular endothelial growth factor-C （VEGF-C）/vascular endothelial growth factor receptor 3 （VEGFR-3） expression and clinicopathologic features of the patients with non-small cell lung cancer （NSCLC） was investigated. The expression of VEGF-C and VEGFR-3 was assessed in 65 patients with NSCLC by immunohistochemistry. The significance of VEGF-C and VEGFR-3 expression was analyzed statistically. The results showed that VEGF-C and VEGFR-3 were highly expressed in cytoplasm and membrane in lung cancer tissues with the positive rate being 55.4 % and 52.3 % respectively, while there was no expression in the normal lung tissues. The expression of VEGF-C was significantly increased in adenocacinoma as compared to other types of NSCLC （P〈0.05）. The VEGFR-3 expression was closely related with lymph node metastasis （P〈0.01） and TNM stage （P〈0.05）. There was a positive correlation between the VEGF-C and VEGFR-3 expression in NSCLC patients （r=-0.658, P〈0.01）. It is suggested that VEGFR-3 plays an important role in the lymphatic metastasis of NSCLC. The interaction between VEGF-C and VEGFR-3 may be deeply involved in the mechanism of lung cancer metastasis.

Expression of VEGFR2 and NRP-1 in non-small cell lung cancer and their clinical significance

Objective： Vascular-targeted therapy is gradually becoming more appealing for patients with lung cancer. It is unclear whether vascular endothelial growth factor receptor 2（VEGFR2） and neuropilin-1（NRP-1） can be biomarkers for clinical treatment. We aimed to investigate the expression levels of VEGFR2 and NRP-1 in human non-small cell lung cancer（NSCLC） and their clinical significance by observing patient prognosis. Methods： VEGFR2 and NRP-1 were assessed by immunohistochemistry（IHC） in 40 patients with NSCLC and in 10 patients with benign lesions of lung; kinase insert domain receptor（KDR） and NRP-1 copy number gain（CNG） was assessed by fluorescence in situ hybridization（FISH）. The distributions of overall survival（OS） and progression-free survival（PFS） were estimated using the Kaplan-Meier method and compared between groups by log-rank test.Results： Rates of positive immunostaining for VEGFR2 and NRP-1 were 58% and 55%, respectively. KDR and NRP-1 CNG（＋） were detected in 32.5% and 30% of tumors, respectively. Levels of both VEGFR2 and NRP-1 in lung tumors were significantly different than in the control tissue（χ2=11.22, P=0.001; χ2=9.82, P=0.001, respectively）; similar results were obtained using CNGs（χ2=4.39, P=0.036; χ2=3.95, P=0.046, respectively）. Statistically significant correlations were observed with histological grade, clinical TNM stage and the lymph node status（P〈0.05）, but not age, gender or pathology type（P〉0.05）. VEGFR2 showed a strong correlation with NRP-1（Rs=0.68, P=0.00）; similar results were observed with KDR and NRP-1 CNG（Rs=0.32, P=0.04）. Significant differences in OS and PFS were observed between the groups with higher VEGFR2 and NRP-1 and those with lower expression（P〈0.05）. Conclusions： According to these data, VEGFR2 and NRP-1 are highly expressed in NSCLC. We can conclude that they play a key role in NSCLC occurrence, development and metastasis and are associated with patient prognosis（P〈0.05 for OS and PFS）. This information will be beneficial for clinical antiangiogenic treatment in NSCLC.

Association of Polymorphic Variants of <i>VEGF</i>and <i>KDR</i>Genes with Development and Metastasing of Non-Small Cell Lung Cancer

Vascular endothelial growth factor (VEGF) is one of the most important and specific factors affecting angiogenesis in tumor development. VEGFR2 is a receptor encoded by the KDR gene. VEGF and VEGFR2 transmit a signal to intracellular tyrosine kinase cascades. Polymorphic variants of the VEGF and KDR genes significantly influence the expression levels of the endothelial growth factor and its receptor, which leads to a change in the activation of angiogenesis in oncopathological processes. In this study, the relationship between the polymorphic variants rs2010963, rs699947 and rs3025039 of the VEGF gene and rs1870377 and rs2071559 of the KDR gene was analyzed with the development of a specific histological type of non-small cell lung cancer and its clinical and morphological characteristics. It was established that the development of squamous cell carcinoma is associated with -634CC genotype of the VEGF gene and the genotypes containing -2578A allele of the VEGF gene reduce the likelihood of this cancer type development. The development of adenocarcinoma is associated with +936CC VEGF/1719TT KDR and +936CT VEGF/1719TT KDR combinations. In women with non-small cell lung cancer, -634GC genotype of the VEGF gene is associated with a greater degree of the primary lesion spread. Genotype -2578СС of the VEGF gene is associated with a higher degree of the primary tumor spread in the general group of patients and with regional metastases in women. Haplotypes -634G/-2578C/+936C are risky for the occurrence of metastases in regional lymph nodes in women.

Molecularly targeted therapies for advanced or metastatic non-small-cell lung carcinoma

Non-small-cell lung cancer(NSCLC)remains the leading cause of cancer-related death in both men and women in the United States.Platinum-based doublet chemotherapy has been a standard for patients with advanced stage disease.Improvements in overall survival and quality of life have been modest.Improved knowledge of the aberrant molecular signaling pathways found in NSCLC has led to the development of biomarkers with associated targeted therapeutics,thus changing the treatment paradigm for many NSCLC patients.In this review,we present a summary of many of the currently investigated biologic targets in NSCLC,discuss their current clinical trial status,and also discuss the potential for development of other targeted agents.

Clinicopathological and Prognostic Significance of Hypoxia-inducible Factor-1 alpha in Lung Cancer: a Systematic Review with Meta-analysis

Hypoxia-inducible factor-1 alpha（HIF-1α） plays a vital role in the initiation, evaluation and prognosis in lung cancer. The prognostic value of HIF-1α reported in diverse study remains disputable. Accordingly, a meta-analysis was implemented to further understand the prognostic role of HIF-1α in lung cancer. The relationship between HIF-1α and the clinicopathological characteristics and prognosis of lung cancer were investigated by a meta-analysis. Pub Med and Embase were searched from their inception to January 2015 for observational studies. Fixed-effects or random-effects meta-analyses were used to calculate odds ratios and 95% confidence intervals of different comparisons. A total of 20 studies met the criteria. The results showed that HIF-1α expression in lung cancer tissues was significantly higher than that in normal lung tissues. Expression of HIF-1α in patients with squamous cell carcinoma was significantly higher than that of patients with adenocarcinomas. Similarly, non-small cell lung cancer（NSCLC） patients had higher HIF-1α expression than small cell lung cancer（SCLC） patients. Moreover, lymph node metastasized tissues had higher HIF-1α expression than non-lymph node metastasized tissues. A high level HIF-1α expression was well correlated with the expression of vascular endothelial growth factor and epidermal growth factor receptor in the NSCLC. Notably, NSCLC or SCLC patients with positive HIF-1α expression in tumor tissues had lower overall survival rate than patients with negative HIF-1α expression. It was suggested that HIF-1α expression may be a prognostic biomarker and a potential therapeutic target for lung cancer.

自拟健脾除积方联合免疫检查点抑制剂治疗对晚期非小细胞肺癌患者的临床疗效及对其外周血管生长因子的影响

目的 探究自拟健脾除积方联合免疫检查点抑制剂治疗对晚期非小细胞肺癌患者的临床疗效及对其外周血管生长因子的影响。方法 选取2021年6月—2022年12月期间河北省沧州中西医结合医院收治的晚期非小细胞肺癌患者70例,按随机数字表法分为对照组和治疗组,每组各35例。对照组给予常规化疗方法,采用信迪利单抗联合含铂双药治疗,治疗组在对照组的基础上加用自拟健脾除积方治疗。每21 d(3周)为一个治疗周期,两组患者连续接受2个疗程的药物治疗,观察比较两组患者临床疗效、不良反应情况,治疗前后中医临床证候评分、KPS评分、血管生长因子(Vascular endothelial growth factor,VEGF)水平。结果 治疗后治疗组总有效率88.57%(31/35)明显高于对照组65.71%(23/35),差异有统计学意义(P<0.05)。治疗后两组患者中医证候评分均较治疗前降低,功能状态疗效KPS评分均较治疗前升高,差异有统计学意义(P<0.05);且治疗组中医证候评分明显低于对照组,功能状态疗效KPS评分明显高于对照组,差异有统计学意义(P<0.01)。治疗后两组患者血清VEGF水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血清VEGF水平明显低于对照组,差异有统计学意义(P<0.05)。两组患者不良反应分级比较,差异无统计学意义(P>0.05)。治疗组白细胞计数降低、恶心/呕吐发生率明显低于对照组,差异有统计学意义(P<0.05)。结论 自拟健脾除积方联合免疫检查点抑制剂治疗晚期非小细胞肺可提高临床治疗效果,改善中医证候评分,提高生活质量,降低外周血血管生长因子含量,且具有相当的安全性,值得推荐使用。

VEGFR2、miR-21、UCP1及UCP3在非小细胞肺癌组织中表达及与其预后的相关性分析

目的分析血管内皮细胞生长因子受体2(VEGFR2)、微小RNA-21(miR-21)、解偶联蛋白1(UCP1)、解偶联蛋白3(UCP3)在非小细胞肺癌(NSCLC)组织内的表达及与其预后的相关性。方法选取98例NSCLC患者,术中取其癌组织与癌旁正常组织,检测VEGFR2、miR-21、UCP1及UCP3表达;分析VEGFR2、miR-21、UCP1及UCP3表达与其临床病理特征的关系;随访1年,分析VEGFR2、miR-21、UCP1及UCP3表达与患者生存率的关系。结果癌组织内的VEGFR2、UCP1阳性表达率及miR-21相对表达量高于癌旁正常组织,UCP3阳性表达率低于癌旁正常组织,差异有统计学意义(P<0.05);VEGFR2、miR-21、UCP1及UCP3表达与淋巴结转移、临床分期、分化程度有关(P<0.05);VEGFR2、UCP1阳性表达及miR-21高表达患者的1年生存率分别低于VEGFR2、UCP1阴性表达及miR-21低表达患者,UCP3阳性表达患者的1年生存率高于UCP3阴性表达者,差异有统计学意义(P<0.05)。结论VEGFR2、miR-21、UCP1及UCP3在NSCLC癌组织内呈异常表达,与患者的预后具有紧密联系。

Effect and Mechanism of Ginsenoside Rg3 on Postoperative Life Span of Patients with Non-Small Cell Lung Cancer

Objective： To explore the effect and mechanism of ginsenoside Rg3 （Shenyi Capsule, 参一胶囊） on the postoperative life span of patients with non-small cell lung cancer （NSCLC）. Methods： The prospective, randomized, controlled method was adopted. One hundred and thirty- three patients with NSCLC were randomly assigned to 3 groups： Shenyi Capsule group （43 cases）, combined therapy group （Shenyi Capsule plus chemotherapy, 46 cases）, and chemotherapy group （44 cases）. The survival rates, immune function and the correlation between vascular endothelial growth factor （VEGF） expression and clinical effect were analyzed in the three groups. Results： （1） The 1-year survival rate in the Shenyi group, the combined group and the chemotherapy group was 76.7% （33/43）, 82.6% （38/46）, and 79.5% （35/44）, respectively; the 2-year survival rate was 67.4% （29/43）, 71.7% （33/46）, and 70.5% （31/44）, respectively; and the 3-year survival rate was 46.5% （20/43）, 54.3% （25/46）, and 47.7% （21/44）, respectively. There was no significant difference among the 3 groups （P〉0.05）. （2） NK cells were increased to different degrees and the ratio of CD4/CD8 was normal in the Shenyi Capsule group and the combined group, while the ratio of CD4/CD8 was disproportional in the chemotherapy group. （3） In the chemotherapy group, the 3-year survival rate was lower in patients with positive expression of VEGF than in patients with negative expression （37.0% vs 64.7%, χ^2=17.9, P〈0.01）, but no significant statistical difference was shown in the other two groups （53.6% vs 55.6%, P〉0.05; 44.4% vs 50.0%, P〉0.05）. Conclusion： Shenyi Capsule, especially in combination with chemotherapy, can improve the life span of patients with NSCLC after operation. The mechanism might be correlated with improving the immune function and anti-tumor angiogenesis.

单操作孔电视胸腔镜肺癌根治术治疗非小细胞肺癌患者的疗效观察

目的观察单操作孔电视胸腔镜(VATS)肺癌根治术对非小细胞肺癌(NSCLC)血管内皮生长因子受体2(VEGFR2)、胸苷激酶1(TK1)水平的影响。方法我院收治的245例NSCLC患者,按手术方式分为对照组(三孔胸腔镜肺癌根治术,n=115)和观察组(单操作孔VATS肺癌根治术,n=130),比较两组围术期指标、视觉模拟(VAS)评分、肺功能、炎性因子、肿瘤标志物、VEGFR2、TK1水平及并发症。结果观察组术中出血量较对照组少(P<0.05);术后,观察组VAS评分、炎性因子、肿瘤标志物和VEGFR2、TK1水平低于对照组,肺功能高于对照组(P<0.05)。结论单操作孔VATS肺癌根治术治疗NSCLC出血量少、疼痛轻,可改善肺功能,降低炎性因子、肿瘤标志物和VEGFR2、TK1水平,且不增加术后并发症,值得临床推广。

非小细胞肺癌患者血清长链非编码RNA及血管内皮生长因子的表达变化及相关性研究

目的:探究非小细胞肺癌患者血清长链非编码RNA(lncRNA)及血管内皮生长因子(VEGF)的表达变化及相关性。方法:2020年1月—2023年5月武汉科技大学附属天佑医院收治的90例非小细胞肺癌患者为观察组,同时期收治的40例肺部良性病变患者为对照组。检测及比较两组血清lncRNA(lncRNA H19、lncRNA DANCR及lncRNA ANRIL)及VEGF(VEGF-A、VEGF-C及VEGF-D)的表达水平,并比较观察组中不同性别、年龄、疾病分期、分化程度及淋巴结转移情况患者的血清lncRNA及VEGF表达水平,采用Pearson相关性分析非小细胞肺癌患者上述血清lncRNA与VEGF的相关性。结果:观察组血清lncRNA与血清VEGF均显著高于对照组(P<0.05);观察组中不同疾病分期及淋巴结转移情况患者的血清lncRNA与VEGF比较,差异均有统计学意义(P<0.05);Pearson相关性分析显示,非小细胞肺癌患者的血清lncRNA与VEGF均呈正相关(P<0.05)。结论:非小细胞肺癌患者lncRNA H19、lncRNA DANCR及lncRNA ANRIL及VEGF均呈现高表达状态,且上述lncRNA与VEGF均呈正相关,在非小细胞肺癌早期诊断中具有一定价值。

重组人血管内皮抑制素对中晚期非小细胞肺癌肿瘤因子的影响

目的:探讨中晚期非小细胞肺癌(NSCLC)利用重组人血管内皮抑制素方案对治疗效果的影响。方法:选取2020年4月—2023年1月兖矿新里程总医院肿瘤三科收治的中晚期NSCLC患者98例,以随机法分组,分成观察组及对照组,各49例。对照组应用常规化疗方案,持续3个疗程,观察组在对照组基础上加用重组人血管内皮抑制素,持续3个疗程。对比两组治疗效果,对比两组治疗前与治疗3个疗程血清细胞角蛋白19片段(Cyfra21-1)、血管内皮生长因子(VEGF)水平、癌胚抗原(CEA)指标水平,对比两组治疗前与治疗3个疗程的生活质量(SF-36)评分,观察并对比两组不良反应发生率。结果:观察组总有效率高于对照组(P<0.05);治疗3个疗程,两组血清CEA、Cyfra21-1、VEGF均下降,而观察组均比对照组低,差异均有统计学意义(P<0.05);治疗3个疗程,两组生活质量评分均高于治疗前,观察组均高于对照组,差异均有统计学意义(P<0.05);疗程期间两组不良反应差异均无统计学意义(P>0.05)。结论:重组人血管内皮抑制素协助传统化疗制剂用于中晚期NSCLC的治疗,有助于下调血清CEA、Cyfra21-1、VEGF水平,提升生活质量的同时也不会加重不良反应。

华蟾素胶囊联合多西紫杉醇+顺铂化疗用于非小细胞肺癌患者的疗效

目的 探究华蟾素联合多西紫杉醇+顺铂化疗用于非小细胞肺癌患者的疗效。方法 选取2019年3月至2022年3月浙江省荣军医院收治的70例非小细胞肺癌患者,随机分为联合组(n=35,华蟾素联合多西紫杉醇+顺铂化疗),对照组(n=35,多西紫杉醇+顺铂化疗)。用ELISA测定血管内皮生长因子(VEGF)、癌胚抗原(CEA)、细胞角蛋白19(CK19)、糖类抗原125(CA125)水平;用卡氏状态(KPS)评分评估患者的生活质量;比较两组不良反应情况。结果 联合组疾病控制率(33/35,94.29%)高于对照组(25/35,71.43%)(P<0.05)。治疗后,两组患者VEGF水平均降低,KPS评分均升高(P<0.05),联合组更佳(P<0.05)。治疗后,对照组和联合组患者血清CEA、CA125和CK19水平明显低于治疗前(P<0.05),联合组低于对照组(P<0.05)。联合组不良反应发生率(5/35,14.29%)低于对照组(13/35,37.14%)(P<0.05)。结论 华蟾素联合多西紫杉醇+顺铂化疗治疗非小细胞肺癌的效果较好,使肿瘤标志物以及VEGF水平下降并且安全性较高。

PEG3、STMN1基因在非小细胞肺癌的表达及其与临床病理特征、血管生成相关性研究

目的 探讨父系表达基因3(PEG3)、抑微管装配蛋白1(STMN1)基因在非小细胞肺癌(NSCLC)的表达及其与临床病理特征和血管生成的关系。方法 收集宁夏医科大学总医院肿瘤医院2021年1月—2023年1月经病理证实的96例NSCLC患者癌组织及癌旁组织,采用实时荧光定量聚合酶链反应(qRT-PCR)检测和免疫组织化学检测癌组织与癌旁组织PEG3、STMN1、VEGF及CD105 mRNA的表达;比较不同临床病理特征NSCLC患者癌组织PEG3、STMN1的阳性表达率;采用Pearson法分析PEG3、STMN1与VEGF及CD105关系;采用受试者工作特征(ROC)曲线分析PEG3、STMN1对NSCLC的诊断价值。结果 与癌旁组织比较,PEG3在NSCLC组织中表达降低(P <0.05),STMN1、VEGF及CD105在NSCLC组织中表达升高(P <0.05);NSCLC组织中STMN1、VEGF及CD105阳性率分别为62.50%、69.79%和72.92%,分别高于癌旁组织5.21%、10.42%和13.54%(P <0.05),NSCLC组织中PEG3阳性率为8.33%低于癌旁组织73.96%(P <0.05);不同年龄、性别及肿瘤类型NSCLC患者的PEG3及STMN1表达水平比较,差异无统计学意义(P>0.05),不同TNM分期、淋巴结转移及分化程度NSCLC患者的PEG3及STMN1表达水平比较,差异有统计学意义(P <0.05);NSCLC组织的PEG3与STMN1、VEGF及CD105均呈负相关(P <0.05),NSCLC组织的STMN1与PEG3呈负相关(P <0.05),与VEGF及CD105均呈正相关(P <0.05);PEG3诊断NSCLC的曲线下面积为0.750(95%CI:0.453,0.936)、敏感性为73.66%(95%CI:0.650,0.937)、特异性为79.62%(95%CI:0.590,0.956);STMN1诊断NSCLC的曲线下面积为0.796(95%CI:0.540,0.942)、敏感性为80.30%(95%CI:0.744,0.978)、特异性为81.12%(95%CI:0.612,0.996);PEG3+STMN1联合诊断的曲线下面积为0.935(95%CI:0.753,0.995)、敏感性为92.33%(95%CI:0.751,0.930)、特异性为77.12%(95%CI:0.735,0.948)。结论 NSCLC组织PEG3降低、STMN1升高,与肺癌TNM分期、分化程度相关,其可以加快肿瘤血管生成,能够一定程度提高疾病诊断价值。

贝伐珠单抗联合奥希替尼对EGFR-T790M突变晚期NSCLC患者细胞免疫功能及血管相关生长因子的影响

目的探讨贝伐珠单抗联合奥希替尼治疗表皮生长因子受体(EGFR)-T790M晚期突变非小细胞肺癌(NSCLC)的临床疗效及可能作用机制。方法回顾性分析2020年1月至2022年5月接受治疗的EGFR-T790M突变晚期NSCLC患者88例,根据治疗方法分为观察组46例和对照组42例。对照组给予奥希替尼治疗,观察组给予贝伐珠单抗联合奥希替尼治疗,比较2组细胞免疫功能、血管相关生长因子、不良反应、近期疗效等。结果观察组缓解率60.87%、疾病控制率86.96%高于对照组的38.10%、66.67%(χ^(2)=4.555,5.147,P<0.05)。CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。血清血管内皮生长因子、血小板衍生生长因子、转化生长因子-β1、碱性成纤维细胞生长因子低于对照组(P<0.05)。2组消化道反应、肝功能损伤、肾功能损伤、神经毒性、血小板减少、白细胞减少比较,差异无统计学意义(P>0.05)。结论贝伐珠单抗联合奥希替尼治疗能够提高EGFR-T790M突变晚期NSCLC患者治疗效果,可能与改善细胞免疫功能、抑制相关血管生长因子水平等因素有关。

贝伐珠单抗与GC化疗方案联合治疗晚期非小细胞肺癌的效果及药物经济学评价

目的 探究贝伐珠单抗联合GC化疗方案(顺铂+吉西他滨)治疗晚期非小细胞肺癌(NSCLC)的效果及药物经济学价值。方法 选取2020年7月—2022年7月收治的86例晚期NSCLC,依据治疗方案分为对照组和观察组,每组43例。对照组给予GC化疗方案,观察组给予贝伐珠单抗联合GC化疗方案。对比2组疗效、毒副反应发生情况以及治疗前后血生化指标,并进行成本-效果分析。结果 观察组客观缓解率58.14%(25/43)、疾病控制率93.02%(40/43)均高于对照组的32.56%(14/43)、72.09%(31/43)(P<0.05)。治疗2、4个疗程,观察组血清癌胚抗原、糖类抗原125、神经元特异性烯醇化酶、血管内皮生长因子、碱性成纤维细胞生长因子均低于对照组(P<0.05)。2组各项毒副反应总发生率比较无显著差异(P>0.05)。观察组总成本高于对照组(P<0.05)。观察组成本-效果比为790.67低于对照组的901.31,且敏感性分析显示,成本-效果分析稳定可靠。结论 贝伐珠单抗联合GC化疗方案治疗晚期NSCLC患者,可下调肿瘤标志物及血管内皮因子水平,提升疗效,且成本-效果优势明显。

血管内皮生长因子与卡瑞利珠单抗治疗晚期非鳞非小细胞肺癌所致反应性毛细血管增生症的相关性

目的探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)对卡瑞利珠单抗(又称SHR‑1210)治疗晚期非鳞非小细胞肺癌(non‑squamous non‑small cell lung cancer,nsNSCLC)所致反应性毛细血管增生症(reactive cutaneous capillary endothelial proliferation,RCCEP)的预测作用以及两者间的相关性。方法回顾性分析我院经卡瑞利珠单抗治疗并检测VEGF的64例晚期nsNSCLC患者。将治疗后发生RCCEP的46例患者纳入A组,未发生RCCEP的18例患者纳入B组,对比两组的治疗效果及VEGF正常率,分析VEGF对RCCEP发生的预测作用,以及两者之间的相关性。结果A组和B组的客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)差异无统计学意义(P>0.05);A组VEGF高于正常值的患者明显多于B组,差异有统计学意义(P<0.001);VEGF数值预测RCCEP发生的ROC曲线下面积为0.908,预测的灵敏度为80.4%,特异度为83.3%,误诊率为16.7%,漏诊率为19.6%,约登指数为63.7%;VEGF水平和RCCEP分级之间呈正相关(r_(s)=0.806,P<0.001)。结论卡瑞利珠治疗后发生RCCEP的患者中VEGF高于正常值的发生率较多,VEGF水平对发生RCCEP有一定的预测性,其灵敏度和特异度较高,且RCCEP分级随着VEGF数值增加而升高。

卡瑞利珠单抗联合化疗治疗晚期非小细胞肺癌的疗效及对患者血清肿瘤标志物、血管内皮生长因子和基质金属蛋白酶-9的影响

目的探讨卡瑞利珠单抗联合化疗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、血管内皮生长因子(VEGF)和基质金属蛋白酶-9(MMP-9)的影响。方法选取2019年1月至2021年12月淄博岜山万杰医院肿瘤科收治的62例晚期NSCLC患者作为研究对象,随机分为观察组与对照组,每组31例。对照组给予依托泊苷联合顺铂化疗方案,观察组在对照组基础上联合卡瑞利珠单抗治疗。比较两组临床疗效、治疗前后血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原72-4(CA72-4)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)]、VEGF和MMP-9水平。结果观察组治疗总有效率为54.84%,高于对照组的29.03%,差异有统计学意义(P<0.05);治疗后,两组CEA、CA72-4和CYFRA21-1水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组VEGF、MMP-9水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论卡瑞利珠单抗联合化疗可有效提高晚期NSCLC患者近期疗效,降低血清肿瘤标志物水平,抑制VEGF和MMP-9表达,有效防止肿瘤转移和侵袭,效果优于单纯化疗。