血管生成相关因子评估贝伐单抗一线治疗老年转移性结直肠癌预后的潜在价值-东南大学学报医学版

血管生成相关因子评估贝伐单抗一线治疗老年转移性结直肠癌预后的潜在价值

单位：1. 武汉市第七医院普外科, 湖北武汉 430061;
2. 湖北理工学院附属医院老年病科, 湖北黄石 435000

分类号：R735.37

出版年·卷·期（页码）：2022·41·第三期（332-339）

摘要：

目的：探讨血清血管生成相关因子作为老年转移性结直肠癌（mCRC）抗血管生成药物一线治疗的预后标志物的潜在价值。方法：2017年6月至2020年5月共纳入125例老年mCRC患者作为研究对象进行队列分析，所有患者均接受贝伐单抗（Bev）联合奥沙利铂基础方案（FOLFOX或CAPOX）。在基线和第2个周期之前（D14）采集血样，用Quantikine酶联免疫吸附测定试剂盒检测血清血管生成相关因子水平。结果：与基线值相比，mCRC患者D14时血清血管生成素-2（Ang-2）水平均降低（P<0.05），但是血清白细胞介素-8（IL-8）水平变化不明显（P>0.05）。肝转移组患者基线血清Ang-2和IL-8水平显著高于未肝转移组患者（P<0.05）。经受试者工作特征曲线分析显示，血清Ang-2和IL-8用于诊断肝转移的最佳临界值分别为1 734.2 pg·ml^-1[曲线下面积（AUC）为0.664，95%CI为0.569~0.759，P<0.001]和13.5 pg·ml^-1（AUC为0.841，95%CI为0.772~0.910，P<0.001）。经单变量分析显示，高Ang-2基线水平和高IL-8基线水平与较短的总生存期（OS）有关（P<0.05）；但多变量分析显示，只有高IL-8基线水平与OS存在相关性（P=0.004）。结论：老年mCRC患者血清IL-8和Ang-2水平与肝转移有关，且IL-8有望成为Bev一线治疗的有效预后标志物。

Objective: To investigate the potential value of serum angiogenesis-related factors as prognostic markers of first-line antiangiogenic therapy in elderly patients with metastatic colorectal cancer(mCRC). Methods: From June 2017 to May 2020, a cohort analysis of 125 elderly patients with mCRC was performed. All patients received bevacizumab(Bev) in combination with the oxaliplatin basic regimen(FOLFOX or CAPOX). Blood samples were taken before baseline and before the second cycle(D14). Serum angiogenic related factors were measured using Quantikine ELISA Kit. Results: Compared with baseline values, serum levels of serum angiogenin-2(Ang-2) decreased(P<0.05), while the serum levels of interleukin-8(IL-8) did not change significantly(P>0.05). Serum levels of Ang-2 and IL-8 in patients with liver metastasis were significantly higher than those in patients without liver metastasis(P<0.05). The receiver operating characteristic curve showed that the best cut-off baseline values of serum Ang-2 and IL-8 were 1 734.2 pg·ml^-1(AUC:0.664, 95%CI:0.569-0.759, P<0.001) and 13.5 pg·ml^-1(AUC:0.841, 95%CI:0.772-0.910, P<0.001), respectively. In univariate analysis, the higher Ang-2 baseline levels, the higher IL-8 baseline levels, the shorter overall survival(OS)(P<0.05). However, multivariate analysis showed only the high IL-8 baseline level remained associated with OS(P=0.004). Conclusion: Serum IL-8 and Ang-2 levels are associated with liver metastasis in elderly mCRC patients. And IL-8 is expected to be an effective prognostic marker for the first-line Bev therapy.

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