贝伐珠单抗联合FOLFOX方案治疗对晚期结直肠癌VEGF、MMPs及COX-2表达的影响

[目的]探讨贝伐珠单抗联合5-氟尿嘧啶(5-Fu)+奥沙利铂(L-OHP)+亚叶酸钙(LV)(FOLFOX方案)化疗对晚期结直肠癌患者血管内皮生长因子(VEGF)、基质金属蛋白酶(MMPs)及环氧化酶-2(COX-2)表达的影响.[方法]90例晚期结直肠癌患者,随机分为对照组与观察组,各45例.两组均采用FOLFOX化疗,观察组加用贝伐珠单抗,比较两组治疗效果及治疗前后患者血清VEGF、MMPs、COX-2表达的变化,采用结直肠癌生活质量量表评价患者治疗前后生活质量的变化,统计两组毒副反应发生率.[结果]①观察组治疗总缓解率高于对照组(P＜0.05);②治疗后,两组VEGF、COX-2、MMP-2、MMP-9表达水平均降低,观察组降低幅度均高于对照组(P＜0.05);③治疗后,两组各维度生活质量评分均上升(P＜0.05),观察组评分上升幅度高于对照组(P＜0.05);④两组毒副反应均以Ⅰ～Ⅱ级白细胞降低、胃肠道反应、贫血为主,观察组无一例出现Ⅲ～Ⅳ级毒副反应,其各级毒副反应发生率略低于对照组,但差异无显著性(P＞0.05).[结论]在晚期结直肠癌患者的临床治疗中,采用贝伐珠单抗联合FOLFOX化疗,患者总缓解率高,VEGF、COX-2、MMP 2、MMP-9表达下调明显,生活质量显著改善,且耐受性好.

Effect of Bevacizumab Combined with FOLFOX on the Expression of VEGF,MMPs and COX-2 in Patients with Advanced Colorectal Cancer

[Objective] To investigate the effect of bevacizumab combined with 5-fluorouracil (5-Fu) + oxaliplatin (L-OHP) + leucovorin (LV) (FOLFOX) chemotherapy on the expression of vascular endothelial growth factor (VEGF),matrix metalloproteinase (MMPs) and cyclooxygenase-2 (COX-2) in patients with advanced colorectal cancer.[Methods]A total of 90 patients with advanced colorectal cancer were equally divided into the control group and the observation group,with 45 cases in each.Both groups were treated with FOLFOX chemotherapy;however,the observation group was additionally treated with bevacizumab.The therapeutic effect was compared between the two groups.The changes in serum VEGF,MMPs and COX-2 were determined before and after treatment.The changes in quality of life before and after treatment were evaluated according to the European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLC-CR37) scale.The incidence rates of side effects in the two groups were statistically analyzed.[Results]① The total remission rate of the observation group was higher than that of the control group (P ＜0.05).② After treatment,the expression levels of VEGF,COX-2,MMP 2 and MMP-9 in both groups were decreased,and the decrease in the observation group was significantly greater than that in the control group (P＜0.05).③ After treatment,the quality of life scores in both groups were increased (P ＜0.05),and the increase in the observation group was greater than that in the control group (P ＜0.05).④ The main side effects in the two groups were grade Ⅰ ～ Ⅱ leukopenia,gastrointestinal reactions and anemia.There was no case of grade Ⅲ ～ Ⅳ side effects in the observation group.The incidence rates of different grades of side effects were slightly lower in the observation group than those in control group (P ＞0.05).[Conclusion]The total remission rate of bevacizumab combined with FOL-FOX chemotherapy is higher than that of routine FOLFOX treatment.The expression of VEGF,COX-2,MMP-2 and MMP-9 is significantly down-regulated.Patient life quality can be improved significantly and the drug tolerance is high as well.