奥拉帕利联合贝伐珠单抗方案对卵巢癌患者近期疗效及血清P-selectin、sICAM-1水平的影响

Effects of olaparib combined with bevacizumab regimen on short-term efficacy and serum P-selectin, sICAM-1 levels in patients with ovarian cancer

摘要:

目的 探讨奥拉帕利与贝伐珠单抗方案联合治疗对卵巢癌患者近期疗效及肿瘤标志物、T淋巴细胞、血清P-选择素（P-selectin）、可溶性细胞间粘附分子-1（sICAM-1）的影响。方法 以2019年1月至2021年5月安阳市肿瘤医院收治的87例卵巢癌患者为研究对象，依据不同治疗方案分为参照组（43例）、研究组（44例）。参照组采用贝伐珠单抗治疗，研究组在参照组基础上增加奥拉帕利治疗。比较两组疾病控制率（DCR）、总缓解率（ORR）、毒副反应发生情况，比较治疗前、治疗30 d后血管内皮生长因子（VEGF）、糖类抗原（CA199、CA125）、癌胚抗原（CEA）、T淋巴细胞（CD4⁺、CD8⁺、CD3⁺、CD4⁺/CD8⁺）、P-selectin及sICAM-1水平。结果 治疗后研究组ORR为70.45%（31/44），高于参照组的48.84%（21/43）（P<0.05）；治疗后两组CEA、CA199、VEGF、sICAM-1、P-selectin及CA125水平均明显下降，其中研究组下降幅度更为显著（P<0.05）；与治疗前比较，两组CD8⁺水平均升高，CD4⁺、CD3⁺、CD4⁺/CD8⁺水平均降低（P<0.05）；两组治疗后CD8⁺、CD4⁺、CD3⁺、CD4⁺/CD8⁺比较，差异无统计学意义（P>0.05）；两组肝肾损伤、血小板减少、胃肠道反应及黏膜出血等毒副反应比较，差异无统计学意义（P>0.05）。结论 奥拉帕利与贝伐利珠单抗联合治疗卵巢癌疗效确切，可抑制新生血管生成，阻止肿瘤细胞扩散转移，降低肿瘤标志物水平，且对机体免疫功能影响较小。

关键词:奥拉帕利;贝伐珠单抗方案;卵巢癌;疗效

Abstract:

Objective To investigate the effects of combination therapy of olaparib and bevacizumab on the short-term efficacy, tumor markers, T lymphocytes, serum P-selectin, and soluble intercellular adhesion molecule-1 (sICAM-1) in patients with ovarian cancer.Methods A total of 87 patients with ovarian cancer admitted to Anyang Cancer Hospital from January 2019 to May 2021 were selected as the study objects, and were divided into reference group (43 cases) and study group (44 cases) according to different treatment regimens. The reference group was treated with bevacizumab, and the study group was additionally treated with olaparib. Disease control rate (DCR), overall response rate (ORR) and incidence of toxic and side effects were compared between the two groups. The levels of vascular endothelial growth factor (VEGF), carbohydrate antigen (CA199, CA125), carcinoembryonic antigen (CEA), T lymphocytes (CD4⁺, CD8⁺, CD3⁺, CD4⁺/CD8⁺), P-selectin and sICAM-1 were compared before treatment and 30 days after treatment.Results After treatment, the ORR of the study group was 70.45% (31/44), higher than that of the control group [48.84% (21/43)], and the difference was statistically significant (P<0.05). After treatment, the levels of CEA, CA199, VEGF, sICAM-1, P-selectin and CA125 were significantly decreased in both groups, and the decrease was more significant in study group (P<0.05). Compared with those before treatment, the level of CD8⁺ was increased, and the levels of CD4⁺, CD3⁺ and CD4⁺/CD8⁺ were decresed in the two groups (P<0.05). After treatment, there were no statistically significant differences in the levels of CD8⁺, CD4⁺, CD3⁺ and CD4⁺/CD8⁺ between the two groups (P<0.05). There was no significant difference in liver and kidney injury, thrombocytopenia, gastrointestinal reaction and mucosal bleeding between the two groups (P>0.05).Conclusion Olaparib combined with bevalizumab is effective in the treatment of ovarian cancer, which can inhibit the formation of neovascularization, prevent the spread and metastasis of tumor cells, reduce the level of tumor markers and has a small impact on the body's immune function.

Key words:olaparib;bevacizumab regimen;ovarian cancer;curative effect