贝伐珠单抗综合治疗Ⅲ期非小细胞肺癌患者的疗效及其对VEGF、MMP-9及COX-2表达的影响

目的 探讨贝伐珠单抗综合治疗Ⅲ期非小细胞肺癌（NSCLC）患者的疗效及其对患者血管内皮生长因子（VEGF）、基质金属蛋白酶-9（MMP-9）及环氧化酶-2（COX-2）表达的影响。方法 回顾性分析安徽省第二人民医院2017年1月至2019年12月收治的95例Ⅲ期NSCLC患者临床资料，并按照治疗方案不同分为联合组47例、化疗组48例。化疗组实施常规化疗，联合组则于常规化疗的基础上增用贝伐珠单抗治疗。比较两组临床疗效，治疗前后血清VEGF、MMP-9及COX-2水平及毒副反应（包括胃肠道反应、神经毒性、血液毒性、手足综合征以及高血压等）差异。结果 联合组症状缓解的总体有效率为85.11%，高于化疗组的62.50%，差异有统计学意义（χ²=6.259，P=0.012）。联合组血清VEGF、MMP-9及COX-2水平治疗前后差值均高于化疗组，差异均有统计学意义（t=121.293、55.989、23.538；P均<0.05）。两组胃肠道反应、神经毒性、血液毒性、手足综合征以及高血压发生率比较，差异均无统计学意义（P均>0.05）。结论 贝伐珠单抗综合治疗Ⅲ期NSCLC患者疗效尚可，且能有效下调VEGF、MMP-9及COX-2水平，安全性较好，值得临床推广应用。

Efficacy of bevacizumab in patients with stage III non-small cell lung cancer and its effect on VEGF, MMP-9, and COX-2 expression

Objective To explore the efficacy ofbevacizumab in patientswithstage III non-small cell lung cancer (NSCLC) and itseffect on the expression of vascular endothelial growth factor (VEGF), matrix metalloproteinase 9 (MMP 9) and cyclooxygenase-2 (COX-2). Methods The clinical data of 95 patients with stage III NSCLCadmitted to Anhui No.2 Provincial People''s Hospital from January 2017 to December 2019 were retrospectivelyanalysed.The patients were divided into the combined group (47 cases) and the chemotherapy group (48 cases) by random number table. The chemotherapy group was treated with conventional chemotherapy and the combination group was treated with bevacizumab on the basis of conventional chemotherapy. The two groups were compared in terms of clinical efficacy, serum VEGF, MMP-9 and COX-2 levels before and after treatment, and toxic and side effects(including gastrointestinal reactions, neurotoxicity, hemotoxicity, hand-foot syndrome and hypertension, etc.). Results The overall effective rate of symptom relief in combined group was 85.11%, higher than that of chemotherapy group (62.50%), and the difference was statistically significant (χ²=6.259, P=0.012). The differencein serum VEGF, MMP-9 and COX-2 levels before and after treatment in combination groupwas higher than thatin chemotherapy group, and the differences were statistically significant(t=121.293, 55.989,23.538; allP<0.05). There was no statistically significant difference in the incidence of gastrointestinal reactions, neurotoxicity, hemotoxicity, hand-foot syndrome and hypertension between the two groups (all P>0.05).Conclusions The treatment ofbeacizumab in stage III NSCLC patients has better curative effectand can effectively lower VEGF, MMP-9 and COX-2 levels with highsecurity, thus it is worth clinical popularization and application.