2023 年第 8 期 第 18 卷

支气管动脉化疗栓塞术联合贝伐珠单抗治疗中晚期非小细胞肺癌的临床效果及对血浆微小RNA-200a和微小RNA-375表达水平的影响

Clinical effect of bronchial arterial chemoembolization combined with bevacizumab in the treatment of advanced non-small cell lung cancer and its effect on the expressions of plasma microRNA-200a and microRNA-375

作者：鲁志刚1王薇2孙嘉阳1

英文作者：Lu Zhigang1 Wang Wei2 Sun Jiayang1

单位：1内蒙古医科大学附属医院胸外科，呼和浩特010000；2内蒙古医科大学附属医院肿瘤内科，呼和浩特010000

英文单位：1Department of Thoracic Surgery the Affiliated Hospital of Inner Mongolia Medical University Hohhot 010000 China; 2Department of Medical Oncology the Affiliated Hospital of Inner Mongolia Medical University Hohhot 010000 China

关键词：非小细胞肺癌；支气管动脉化疗栓塞术；贝伐珠单抗；微小RNA

英文关键词：Non-smallcelllungcancer;Bronchialarterialchemoembolization;Bevacizumab;MicroRNA

• 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）的临床效果及对血浆微小RNA（miR）-200a和miR-375表达水平的影响。方法 选取2018年1月至2020年12月于内蒙古医科大学附属医院就诊的中晚期NSCLC患者81例。完全随机分为观察组41例和对照组40例。对照组采用BACE治疗，观察组采用BACE联合贝伐珠单抗静脉滴注治疗，治疗频率均为1次/3周、治疗4次。观察比较2组临床效果，血浆miR水平变化，Karnofsky评分，胃肠道反应、脱发、骨髓抑制及肝肾功能损伤等药物毒副作用发生情况，以及1年生存率。结果 治疗后观察组疾病控制率高于对照组［65.9%（27/41）比40.0%（16/40）］，差异有统计学意义（χ2=5.434，P=0.020）。治疗后，2组血浆miR-200a、miR-375水平均高于治疗前且观察组高于对照组［（2.89±0.37）比（1.64±0.31）、（3.05±0.42）比（2.12±0.35）］，差异均有统计学意义（均P<0.05）。治疗后2组Karnofsky评分均高于治疗前，且观察组高于对照组［（85±8）分比（76±8）分］，差异有统计学意义（t=4.849，P<0.001）。2组药物毒副作用发生率差异无统计学意义（χ2=0.526，P=0.468）。观察组1年生存率高于对照组［87.8%（36/41）比67.5%（27/40）］，差异有统计学意义（χ2=4.830，P=0.028）。结论 BACE联合贝伐珠单抗治疗中晚期NSCLC临床效果显著，可有效上调血浆miR-200a和miR-375表达水平，提高患者生活质量及1年生存率，不额外增加毒副作用。

• Objective To investigate the clinical effect of bronchial arterial chemoembolization(BACE) combined with bevacizumab on the treatment of advanced non-small cell lung cancer (NSCLC) and its effect on the expressions of plasma microRNA-200a (miR-200a) and miR-375. Methods  From January 2018 to December 2020, 81 patients with advanced NSCLC admitted to the Affiliated Hospital of Inner Mongolia Medical University were selected. Patients were randomly divided into observation group(41 cases) and control group(40 cases). The control group was treated with BACE, while the observation group was treated with BACE combined with bevacizumab intravenous drip, the treatment frequency was 1 time/3 weeks, with 4 times. The clinical effect, change of plasma miR level, Karnofsky score, occurrence of toxic and side effects of drugs such as gastrointestinal reaction, alopecia, bone marrow suppression and liver and kidney function damage, and 1-year survival rate between the two groups were observed and compared. Results After treatment, the disease control rate in the observation group was higher than that in the control group［65.9%(27/41) vs 40.0%(16/40)］（χ2=5.434, P=0.020）. After treatment, the levels of plasma miR-200a and miR-375 in the two groups were higher than those before treatment, and the levels in the observation group were higher than those in the control group［(2.89±0.37) vs (1.64±0.31), (3.05±0.42) vs (2.12±0.35)］(all P<0.05). After treatment, Karnofsky scores in the two groups were higher than those before treatment, and the score in the observation group was higher than in the control group［(85±8) vs (76±8)］(t=4.849, P<0.001). There was no statistically significant difference in the incidence of toxic and side effects of drugs between the two groups（χ2=0.526, P=0.468）. The 1-year survival rate in the observation group was higher than that in the control group［87.8%(36/41) vs 67.5%(27/40)］（χ2=4.830, P=0.028）. Conclusion ss  BACE combined with bevacizumab has significant clinical efficacy in the treatment of advanced NSCLC, which effectively increases the expression levels of plasma miR-200a and miR-375, and improves the quality of life and 1-year survival rate of patients, no additional toxic side effects added.