摘要
目的探讨阿帕替尼联合化疗对ⅢB~Ⅳ期结直肠癌患者肿瘤标志物、血管生成及骨髓抑制的影响。方法选择2018年3月至2019年5月在江苏省仪征市人民医院接受治疗的ⅢB~Ⅳ期结直肠癌患者60例,按照随机数字表法分为观察组(30例)和对照组(30例)。对照组采用常规静脉化疗进行治疗,观察组在对照组治疗方法的基础上联合阿帕替尼进行治疗,比较两组缓解率及骨髓抑制发生率,并比较治疗前后血清癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原242(CA242)、血管内皮生长因子(VEGF)水平及微血管密度(MVD)变化。结果观察组患者的缓解率高于对照组[86.7%(26/30)比63.3%(19/30)],差异有统计学意义(χ^2=4.356,P=0.037)。治疗后,观察组CEA、CA199、CA242水平[(3.1±0.8)ng/ml、(112±17)U/ml、(27±6)U/ml]均高于对照组[(6.6±1.1)ng/ml、(169±22)U/ml、(39±7)U/ml],差异均有统计学意义(t值分别为-14.209、-11.102、-7.384,均P<0.01);观察组VEGF水平及MVD[(41±5)ng/ml、18±3]均低于对照组[(80±7)ng/ml、33±5],差异均有统计学意义(t值分别为-23.161、-13.529,均P<0.01)。观察组骨髓抑制发生率为10.0%(3/30),对照组为6.7%(2/30),差异无统计学意义(P=1.000)。结论阿帕替尼联合化疗可进一步提高ⅢB~Ⅳ期结直肠癌患者的近期疗效,降低肿瘤标志物水平,抑制血管生成,且不增加骨髓抑制的发生。
Objective To explore the effects of apatinib combined with chemotherapy on tumor markers,angiogenesis and bone marrow suppression in patients with stageⅢB-Ⅳcolorectal cancer.Methods A total of 60 patients with stageⅢB-Ⅳcolorectal cancer who were treated in Yizheng People's Hospital of Jiangsu Province from March 2018 to May 2019 were selected,they were divided into the observation group(30 cases)and control group(30 cases)according to the random number table method.The control group was treated with conventional intravenous chemotherapy,while the observation group was treated with apatinib on the basis treatment of the control group.The remission rate and incidence of bone marrow suppression were compared between the two groups,and the expressions of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),carbohydrate antigen 242(CA242),vascular endothelial growth factor(VEGF)and microvessel density(MVD)before and after treatment were also compared.Results The remission rate in the observation group was higher than that in the control group[86.7%(26/30)vs.63.3%(19/30)],and the difference was statistically significant(χ^2=4.356,P=0.037).After treatment,the levels of CEA,CA199 and CA242 in the observation group[(3.1±0.8)ng/ml,(112±17)U/ml and(27±6)U/ml]were significantly lower than those in the control group[(6.6±1.1)ng/ml,(169±22)U/ml and(39±7)U/ml],and the differences were statistically significant(t values were-14.209,-11.102 and-7.384,all P<0.01).After treatment,the levels of VEGF and MVD in the observation group[(41±5)ng/ml and 18±3]were significantly lower than those in the control group[(80±7)ng/ml and 33±5],and the differences were statistically significant(t values were-23.161 and-13.529,both P<0.01).The incidence of bone marrow suppression was 10.0%(3/30)in the observation group and 6.7%(2/30)in the control group,and there was no statistical difference between the two groups(P=1.000).Conclusion Apatinib combined with chemotherapy for treatment of patients with stageⅢB-Ⅳcolorectal cancer can further improve the short-term efficacy,reduce the level of tumor markers,inhibit angiogenesis,and do not increase the incidence of bone marrow suppression.
作者
徐燕
王勇
相雷
张信强
Xu Yan;Wang Yong;Xiang Lei;Zhang Xinqiang(Department of Oncology,Yizheng People's Hospital of Jiangsu Province,Yizheng 211400,China)
出处
《肿瘤研究与临床》
CAS
2020年第6期387-390,共4页
Cancer Research and Clinic
关键词
结直肠肿瘤
肿瘤标志
生物学
血管生成
骨髓抑制
阿帕替尼
Colorectal neoplasms
Tumor markers,biological
Angiogenesis
Bone marrow suppression
Apatinib
