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目的观察组蛋白去乙酰化酶(HDAC)抑制剂——丙戊酸钠(VPA)联合TP(紫杉醇联合顺铂)方案对晚期肺腺癌化疗后血清血管内皮生长因子(VEGF)水平的影响。方法选取2014年7月至2016年3月首次就诊的Ⅳ期肺腺癌患者80例为研究对象,其中VPA联合TP方案组40例,TP方案组40例。采用酶联免疫吸附法(ELISA)检测两组用药前后血清VEGF水平。观察两组客观缓解率及不良反应发生情况并进行比较。结果两组治疗前血清VEGF水平比较无统计学差异(P>0.05)。治疗2周期、4周期后,VPA联合TP方案组血清VEGF水平较TP方案组明显下降,差异有统计学意义(P均<0.01)。VPA联合TP方案组用药2周期后客观缓解率40.0%高于TP方案组的37.5%,4周期后客观缓解率47.5%高于TP方案组的42.5%,但差异无统计学意义(P均>0.05)。VPA联合TP方案组原发灶局部进展率20.0%高于TP方案组的12.5%,但差异无统计学意义(P>0.05);VPA联合TP方案组远处转移率15.0%明显低于TP方案组的35.0%,差异有统计学意义(P<0.05)。两组不良反应发生率比较均无统计学差异(P均>0.05)。结论应用HDAC抑制剂——VPA联合TP方案治疗晚期肺腺癌,在不增加不良反应的前提下,可能通过抑制VEGF,降低远处转移率,改善患者的生活质量。
Objective To investigate the effect of HDAC inhibitor VPA combined with TP (paclitaxel plus cisplatin) on the level of serum vascular endothelial growth factor (VEGF) in patients with advanced lung adenocarcinoma after chemotherapy. Methods Totally 80 patients with stage Ⅳ lung adenocarcinoma from July 2014 to March 2016 were enrolled. Among them, 40 cases were VPA combined with TP and 40 cases were TP. Serum VEGF levels were measured by enzyme-linked immunosorbent assay (ELISA) before and after treatment. Objective observation of two groups of objective response rates and adverse reactions occurred and compared. Results There was no significant difference in serum VEGF levels between the two groups before treatment (P> 0.05). After 2 cycles and 4 cycles of treatment, the level of serum VEGF in VPA combined TP group was significantly lower than that in TP group (P <0.01). The objective response rate was 40.0% in VPA combined TP group after 2 cycles, 37.5% in TP group, and 47.5% in 4 weeks after CPT group. The difference was not statistically significant (P> 0.05). VPA combined with TP regimen group primary tumor progression rate was 20.0% higher than the TP regimen group 12.5%, but the difference was not statistically significant (P> 0.05); VPA combined TP regimen group distant metastasis rate 15.0% was significantly lower than the TP program The difference was statistically significant (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (all P> 0.05). Conclusions The application of HDAC inhibitor - VPA in combination with TP regimen in the treatment of advanced lung adenocarcinoma may improve the quality of life of patients with advanced lung adenocarcinoma by inhibiting VEGF, reducing the distant metastasis rate without increasing adverse reactions.