作者：辛鑫，梁志伟，余会敏，郧立杰

单位：

1.050011河北省石家庄市第三医院介入科 2.056200河北省邯郸市，华北医疗健康集团峰峰总医院胸外科 通信作者：辛鑫，E-mail：xaw78p7pac@21cn.com

Units：

1.Department of Intervention, the Third Hospital of Shijiazhuang, Shijiazhuang 050011, China 2.Department of Thoracic Surgery, Huabeiyiliao Jiankangjituan Fengfeng Zongyiyuan, Handan 056200, China Corresponding author: XIN Xin, E-mail: xaw78p7pac@21cn.com

关键词：

非小细胞肺癌; 支气管动脉栓塞; 贝伐珠单抗; miR-200a; miR-375;

Keywords：

Non-small cell lung cancer; Bronchial artery embolization; Bevacizumab; miR-200a; miR-375

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.098

Funds：

河北省医学科学研究课题计划项目（20221663，20181054）

摘要：

目的 探讨支气管动脉化疗栓塞术(BACE)联合贝伐珠单抗治疗中晚期非小细胞肺癌(NSCLC)患者的疗效及其对血浆miR-200a、miR-375表达水平的影响。方法 选择2018年1月至2020年1月石家庄市第三医院收治的中晚期NSCLC患者172例,采用随机数字表法分为对照组和观察组,各86例。对照组患者采用BACE治疗4个周期,观察组患者采用BACE联合贝伐珠单抗治疗4个周期。比较两组患者临床疗效、血浆miR-200a、miR-375表达水平、毒副作用及生存状态。结果 172例患者中168例完成治疗,每组84例。治疗后,两组患者客观缓解率(ORR)比较,差异无统计学意义(χ2=0.807,P=0.369);观察组患者疾病控制率(DCR)高于对照组(χ2=5.364,P=0.021)。治疗后两组患者血浆miR-200a、miR-375表达水平分别高于本组治疗前,且观察组患者血浆miR-200a、miR-375表达水平高于对照组(P<0.05)。两组患者Ⅲ度及以上毒副作用总发生率比较,差异无统计学意义(χ2=0.339,P=0.560)。中位随访时间为25(12～36)个月,观察组和对照组患者中位无进展生存期(PFS)分别为9〔95%CI(5,14)〕个月、9〔95%CI(4,12)〕个月,中位总生存期(OS)分别为21〔95%CI(15,26)〕个月、17〔95%CI(13,21)〕个月。两组患者无进展生存率比较,差异无统计学意义(20.25%比20.77%,χ2=2.546,P=0.111);观察组患者总生存率高于对照组(29.11%比38.96%,χ2=4.902,P=0.027)。结论 BACE联合贝伐珠单抗治疗中晚期NSCLC患者,能上调miR-200a、miR-375表达水平,提高DCR,延长患者OS,优于单独BACE治疗。

Abstract：

esponding author: XIN Xin, E-mail: xaw78p7pac@21cn.com【Abstract】 Objective To evaluate the efficacy of bronchial arterial chemoembolization (BACE) combined withbevacizumab in the treatment of intermediate or advanced non-small cell lung cancer (NSCLC) patients and its effect on theexpression level of miR-200a and miR-375 in plasma. Methods A total of 172 patients with intermediate or advanced NSCLCadmitted to the Third Hospital of Shijiazhuang from January 2018 to January 2020 were selected and divided into the control groupand the observation group by random number table method, with 86 cases in each group. The control group was treated with BACEfor 4 cycles, and the observation group was treated with BACE combined with bevacizumab for 4 cycles. The clinical efficacy,expression levels of miR-200a and miR-375 in plasma, toxic and side effects, survival statas were compared between the twogroups. Results Among 172 patients, 168 patients completed the treatment, with 84 cases in each group. After treatment, therewas no significant difference in objective remission rate (ORR) between the two groups (χ2 =0.807, P=0.369) ; the disease controlrate (DCR) of observation group was higher than that of control group (χ2 =5.364, P=0.021) . After treatment, the expression levelsof miR-200a and miR-375 in plasma in the two groups were higher than those before treatment, and the expression levels of miR-200a and miR-375 in plasma in observation group were higher than those in control group (P < 0.05) . There was no significantdifference in incidence of Ⅲ degree and above toxic and side effects between the two groups (χ2=0.339, P=0.560) . The medianfollow-up time was 25 (12-36) months. The median progression free survival (PFS) of the observation group and the control groupwere 9 [95%CI (5, 14) ] months and 9 [95%CI (4, 12) ] months respectively, and the median overall survival (OS) were 21 [95%CI(15, 26) ] months and 17 [95%CI (13, 21) ] months respectively. There was no significant difference in progression free survivalrate between the two groups (20.25% vs. 20.77%, χ2 =2.546, P=0.111) . The overall survival rate of observation group was higherthan that of control group (29.11% vs. 38.96%, χ2 =4.902, P=0.027) . Conclusion BACE combined with bevacizumab in thetreatment of intermediate or advanced NSCLC patients can up-regulate the expression levels of miR-200a and miR-375, improvethe DCR and prolong the OS of patients, which is superior to BACE alone.

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