【摘要】 目的:观察经过安罗替尼治疗的不同瘤种恶性肿瘤患者的相关指标，探索影响安罗替尼临床疗效和预后的因素。方法:2018年7月至2019年12月使用安罗替尼治疗的晚期恶性肿瘤患者101例，取患者治疗过程中的血液，用ELISA法和实时荧光定量PCR法检测血清中VEGF、FGF、c-Kit、Bcl-2、PARP蛋白含量和mRNA相对表达量。另一方面，评价安罗替尼的疗效和随访观察PFS。结果:全部病例的总的中位PFS为4.8月(95%CI:3.8～5.8),PR 18例(17.82%),SD 61例(60.40%),PD 22例(21.78%),ORR 17.82%,DCR 78.22%。TSH升高患者的DCR较未发生者高(P=0.039 0)。既往曾使用铂类化疗者较未使用者具有更长的中位PFS(5.3月vs 3.6月，Log-rank P=0.038 0),TSH升高患者较未升高患者的中位PFS显著延长(6.4月vs 4.0月，Log-rank P=0.046 0),发生手足综合征者中位PFS较未发生者显著延长(11.4月vs 4.2月，Log-rankP=0.021 0)。血清bFGF的蛋白含量(P=0.009 0)及Bcl-2 mRNA相对表达量(P=0.012 0)是安罗替尼治疗晚期恶性肿瘤预后的独立影响因子。结论:血清bFGF含量及Bcl-2 mRNA表达量是安罗替尼疗效的独立影响因素；既往曾使用铂类、发生手足综合征和促甲状腺素升高者具有更长的PFS。更多还原

【Abstract】 Objective:To observe the relative indexes of patients with different types of malignant tumors treated with anlotinib and to explore the factors affecting the clinical efficacy and prognosis of anlotinib.Methods:From July, 2018 to December, 2019,101 patients with advanced malignant tumors were treated with anlotinib.The blood of the patients during the treatment was collected, and the serum levels of VEGF,FGF,c-Kit, Bcl-2,PARP and relative mRNA expression were detected by ELISA and real-time quantitative PCR.On the other hand, the efficacy of anlotinib were evaluated, and PFS was observed.Results:The median total PFS was 4.8 months(95%CI:3.8～5.8).There were 18 cases of PR(17.82%),61 cases of SD(60.40%),22 cases of PD(21.78%).ORR was 17.82%,and DCR was 78. 22%. Patients with elevated TSH had higher DCR than those without elevated TSH(P= 0. 039 0).Patients with previous platinum chemotherapy had a longer median PFS(5. 3 months vs 3. 6 months,Log-rankP=0. 038 0). The median PFS of patients with elevated TSH was significantly longer than that of patients without elevatedTSH(6. 4 months vs 4. 0 months,Log-rankP= 0. 046 0),and the median PFS of patients with hand-foot syn-drome was significantly longer than that of patients without elevated TSH(11. 4 months vs 4. 2 months,Log-rankP= 0. 021 0). The protein content of serum bFGF(P= 0. 009 0) and the relative expression of Bcl-2 mRNA(P=0. 012 0)were independent influencing factors for the prognosis of advanced malignant tumors treated with anlotinib.Conclusion:The content of serum bFGF and the expression of Bcl-2 mRNA were independent factors influencing theefficacy of anlotinib. Patients with previous use of platinum,hand-foot syndrome and elevated thyrotropin had longerPFS.更多还原