贝伐珠单抗联合化疗对晚期结直肠癌患者MSH2、MLHI、MSH6和PMS2水平影响

doi:10.20223/j.cnki.1000-8535.2025.06.013

摘要/Abstract

摘要： 目的分析贝伐珠单抗与化疗对晚期结直肠癌患者4种错配修复蛋白（MSH2、MLHI、MSH6、PMS2）水平影响。方法选择2022年1月—2024年1月江苏省宿迁市中医院肿瘤科102例晚期结直肠癌患者,按抽签法分成两组,即化疗组及联合组,各51例。化疗组应用FOLFOX（亚叶酸钙+奥沙利铂+氟尿嘧啶）方案进行化疗,联合组采取贝伐珠单抗联合FOLFOX方案治疗。对比其肿瘤控制效果、免疫功能及MSH2、MLHI、MSH6和PMS2水平变化,并对比组间不良反应发生率。结果联合组客观缓解率、疾病控制率高于化疗组（P<0.05）;治疗后联合组患者CD4⁺、CD3⁺、CD8⁺、和CD4⁺/CD8⁺数值高于化疗组,且两组治疗后均低于治疗前（P<0.05）;治疗后两组患者MSH2、MLHI、MSH6和PMS2缺失率对比无统计学意义（P>0.05）,但其阳性、阴性表达情况对比差异有统计学意义,联合组MSH2、MLHI、MSH6和PMS2阳性率低于化疗组（P<0.05）;两组不良反应发生率对比差异无统计学意义（P>0.05）。结论对晚期结直肠癌在化疗基础上增加贝伐珠单抗抗肿瘤效果显著,改善其免疫功能,虽无法改善患者错配修复蛋白缺损,但可辅助降低其阳性率,且不影响安全性。

关键词: 贝伐珠单抗, 化疗, 结直肠癌, 错配修复蛋白, 不良反应, 免疫功能

Abstract: Objective To analyze the effects of bevacizumab and chemotherapy on the levels of four mismatch repair proteins（MSH2,MLHI,MSH6,PMS2）in patients with advanced colorectal cancer. Methods A total of 102 patients with advanced colorectal cancer from the Oncology Department of Suqian Traditional Chinese Medicine Hospital in Jiangsu Province from January 2022 to January 2024 were selected,and were divided into two groups according to the drawing method,namely the chemotherapy group and the combination group,with 51 patients in each group．The chemotherapy group received FOLFOX（calcium folinate+oxaliplatin+fluorouracil）regimen for chemotherapy,while the combination group received bevacizumab combined with FOLFOX regimen for treatment．Tumor control effect,immune function,and changes in MSH2,MLHI,MSH6,and PMS2 levels,and its incidence of adverse reactions were compared．Results The objective remission rate and disease control rate of the combined group were higher than those of the chemotherapy group（P<0.05）．After treatment,the CD4⁺,CD3⁺,CD8⁺ and CD4⁺/CD8⁺ values in the combination group were higher than those in the chemotherapy group,and those after treatment were lower than those before treatment in both groups（P<0.05）．After treatment,there were no significant differences in the deletion rates of MSH2,MLHI,MSH6,and PMS2 between the two groups of patients（P>0.05）,but there was a significant difference in their positive and negative expression．The positive rates of MSH2,MLHI,MSH6,and PMS2 in the combination group were lower than those in the chemotherapy group（P<0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）．Conclusions Adding bevacizumab on the basis of chemotherapy has a significant anti-tumor effect on advanced colorectal cancer,improving its immune function．Although it cannot improve the mismatch repair protein defect in patients,it can assist in reducing its positivity rate and has high safety．

Key words: bevacizumab monoclonal antibody, chemotherapy, colorectal cancer, mismatch repair protein, adverse reactions, immunity

谢红妹, 杨波, 徐维, 蔡利, 徐培培. 贝伐珠单抗联合化疗对晚期结直肠癌患者MSH2、MLHI、MSH6和PMS2水平影响[J]. 广州医药, 2025, 56(6): 809-814.

XIE Hongmei, YANG Bo, XU Wei, CAI Li, XU Peipei. The effect of bevacizumab combined with chemotherapy on the levels of MSH2,MLHI,MSH6 and PMS2 in patients with advanced colorectal cancer[J]. Guangzhou Medical Journal, 2025, 56(6): 809-814.

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