阿帕替尼联合GEMOX方案对胆囊癌患者临床疗效及肿瘤标志物的影响

摘要/Abstract

摘要： 目的分析阿帕替尼联合GEMOX方案治疗胆囊癌(GC)的疗效。方法选取本院2020年1月至2023年6月收治的98例GC患者,按照信封法分为对照组与观察组。对照组(48例)采取GEMOX方案治疗,观察组(50例)在对照组基础上加用阿帕替尼治疗,比较2组疗效。结果观察组缓解率(ORR)78.00%(39/50)、控制率(DCR)86.00%(43/50)均高于对照组:58.33%(28/48)、68.75%(33/48)(P<0.05)。治疗8周后,观察组癌胚抗原(CEA)(15.69±2.74)ng/mL、血管内皮生长因子(VEGF)(259.64±40.87)ng/mL、可溶性白细胞介素2(sIL-2R)(536.29±42.05)U/mL,均低于对照组[(22.17±3.06)ng/mL、(324.52±49.82)ng/mL、(638.95±52.47)U/mL](P<0.05)。治疗8周后,观察组CD4⁺[(30.14±4.02)%]、CD4⁺/CD8⁺[(0.79±0.12)],均低于对照组[(35.21±4.26)%、(0.93±0.14)],而CD8⁺[(41.26±4.29)%]高于对照组[(38.56±5.02)%,](P<0.05)。观察组卡氏功能状态评分(KPS)(84.26±5.41)分高于对照组[(80.66±5.86)分],简明疲乏量表(BFI)(2.96±0.47)分低于对照组[(4.29±0.63)分](P<0.05)。观察组血压升高、蛋白尿及手足综合征发生率分别为4.00%、6.00%、4.00%,低于对照组的6.25%、6.25%、4.17%,恶心呕吐发生率为8.00%,高于对照组的4.17%(P>0.05)。对两组患者随访6个月,观察组、对照组分别有49例、47例完成最终随访。观察组生存率为91.84%(45/49),高于对照组的82.98%(39/47)。结论 GC患者采取阿帕替尼联合GEMOX方案治疗效果显著,可有效改善患者免疫功能,提升生活质量,降低患者疲乏感,改善肿瘤标志物,临床应用安全性尚可。

关键词: 阿帕替尼, GEMOX方案, 胆囊癌, 肿瘤标志物

Abstract: Objective To evaluate the efficacy of Apatinib combined with GEMOX in the treatment of gallbladder cancer (GC). Methods 98 GC patients admitted to our hospital from January 2020 to June 2023 were enrolled and divided into 2 groups by envelope method, 48 cases in the control group were treated with GEMOX, 50 cases in the observation group were treated with apatinib, and the efficacy of the two groups was compared. Results The overall response rate (ORR) and disease control rate in the observation group were 78.00% (39/50) and 86.00% (43/50), which were higher than those in control group (58.33% (28/48) and 68.75% (33/48) (P<0.05). After 8 weeks of treatment, the CEA (15.69±2.74) ng/mL, VEGF (259.64±40.87) ng/mL and soluble interleukin-2 (sIL-2R) (536.29±42.05) U/mL in the observation group were lower than those in the control group (22.17±3.06) ng/mL, (324.52±49.82) ng/mL, (638.95±52.47) U/mL (P<0.05). After 8 weeks of treatment, CD4⁺ (30.14±4.02) % and CD4⁺/CD8⁺ (0.79±0.12) in observation group were lower than those in control group (35.21±4.26) % and (0.93±0.14). CD8⁺ (41.26±4.29) % was higher than that in the control group (38.56±5.02) % (P<0.05). The KPS score (84.26±5.41) in the observation group was higher than that in the control group (80.66±5.86), and the BFI score (2.96±0.47) was lower than that in the control group (4.29±0.63) (P<0.05). The incidence of elevated blood pressure, proteinuria, and hand foot syndrome (4.00%, 6.00%, 4.00%) in the observation group was lower than that in the control group (6.25%, 6.25%, 4.17%), and the incidence of nausea and vomiting (8.00%) was higher than that in the control group (4.17%, P>0.05). Two groups of patients were followed up for 6 months, 2 cases fell off due to the loss of contact information, 49 cases in the observation group and 47 cases in the control group completed the final follow-up. The survival rate of the observation group was 91.84% (45/49), which was higher than that of the control group (82.98% (39/47), which was statistically analyzed by Log-rank χ² test (χ²=1.721, P=0.190). Conclusion Apatinib combined with GEMOX has significant therapeutic effect on GC patients, which can effectively improve the immune function of patients, enhance the quality of life of patients, reduce the fatigue of patients, improve tumor markers, and the clinical safety is reasonable.

Key words: Apatinib, GEMOX scheme, Gallbladder cancer, Tumor marker

蒋莉莉, 周苏康, 居烨. 阿帕替尼联合GEMOX方案对胆囊癌患者临床疗效及肿瘤标志物的影响[J]. 肝脏, 2026, 31(1): 127-131.

JIANG Li-li, ZHOU Su-kang, JU Ye. Clinical efficacy of apatinib combined with GEMOX in patients with gallbladder cancer and its influence on tumor markers[J]. Chinese Hepatolgy, 2026, 31(1): 127-131.

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