安罗替尼对难治性分化型甲状腺癌VEGF/VEGFR通路及临床获益的影响研究OA
Effect of Anlotinib on the VEGF/VEGFR Pathway and Clinical Benefits in Refractory Differentiated Thyroid Cancer
目的:观察安罗替尼对难治性分化型甲状腺癌(DTC)患者血管内皮生长因子/血管内皮生长因子受体(VEGF/VEGFR)通路及临床获益的影响.方法:前瞻性选择2023年5月至2024年5月就诊于本院的98例难治性DTC患者为研究对象,设计平行对照试验.通过随机分组法将其分为对照组和观察组,每组49例.对照组予以放射性碘治疗(RAI),观察组采用安罗替尼联合RAI治疗,比较两组患者的VEGF/VEGFR通路蛋白、肿瘤微环境、肿瘤负荷,治疗后随访1年,比较两组患者预后情况.分析VEGF/VEGFR与临床指标的相关性.结果:治疗后,观察组的VEGF、VEGFR相对表达量分别为(1.66±0.35)、(1.52±0.41),均低于对照组[(2.53±0.39)、(2.44±0.57)](P＜0.05).观察组的缺氧诱导因子-1α(HIF-1α)、碳酸酐酶Ⅸ(CA9)均高于对照组,基质金属蛋白酶2(MMP2)、基质金属蛋白酶9(MMP9)均低于对照组(P＜0.05).观察组的客观缓解率(ORR)、疾病控制率(DCR)分别为 79.59％(39/49)、87.76％(43/49),均高于对照组[55.10％(27/49)、61.22％(30/49)](P＜0.05).截至随访结束时,观察组的中位无进展生存期(mPFS)、中位总生存期(mOS)均高于对照组(P＜0.05).VEGF、VEGFR均与HIF-1α、CA9呈负相关,均与 MMP2、MMP9 呈正相关(r=-0.751,-0.822,0.745,0.816,-0.733,-0.806,0.814,0.795;P＜0.05).结论:安罗替尼可改善难治性DTC患者的肿瘤微环境并减轻肿瘤负荷,对提升患者短期生存获益有积极影响,其作用机制可能与抑制VEGF/VEGFR通路活性有关.
Objective:To observe the effect of anlotinib on the VEGF/VEGFR pathway and clinical benefits in patients with refractory differentiated thyroid cancer(DTC).Methods:A prospective study was conducted on 98 patients with refractory DTC who were treated in our hospital from May 2023 to May 2024,and a parallel controlled trial was designed.They were divided into the conventional group and the experimental group using a simple random grouping method,with 49 cases in each group.The conventional group was treated with RAI,while the experimental group was treated with anlotinib combined with RAI.The VEGF/VEGFR pathway proteins,tumor microenvi-ronment,and tumor burden were compared between the two groups of patients.After one year of follow-up after treatment,the prognosis of the two groups of patients was compared.Analyze the correlation between VEGF/VEGFR and clinical indicators.Results:After treat-ment,the relative expression levels of VEGF and VEGFR in the experimental group were(1.66±0.35)and(1.52±0.41),respective-ly,which were lower than those in the conventional group[(2.53±0.39),(2.44±0.57)](P＜0.05).The levels of HIF-1α and CA9 in the experimental group were higher than those in the control group,while the levels of MMP2 and MMP9 were lower than those in the control group(P＜0.05).The ORR and DCR of the experimental group were 79.59％(39/49)and 87.76％(43/49),respective-ly,which were higher than those of the control group[55.10％(27/49),61.22％(30/49)](P＜0.05).As of the end of follow-up,the mPFS and mOS of the experimental group were higher than those of the control group(P＜0.05).VEGF and VEGFR are negatively correlated with HIF-1 α and CA9,and positively correlated with MMP2 and MMP9(r=-0.751,-0.822,0.745,0.816,-0.733,-0.806,0.814,0.795,P＜0.05).Conclusion:Anlotinib improves the tumor microenvironment and reduces tumor burden in patients with refractory DTC,and has a positive impact on enhancing short-term survival benefits.Its mechanism of action may be related to the inhibition of VEGF/VEGFR pathway activity.
杨璐;吴东婉;陈笑笑
南阳医学高等专科学校附属中医院,河南南阳 473000南阳医学高等专科学校附属中医院,河南南阳 473000南阳医学高等专科学校附属中医院,河南南阳 473000
医药卫生
难治性分化型甲状腺癌放射性碘治疗安罗替尼血管内皮生长因子/血管内皮生长因子受体临床获益
Refractory differentiated thyroid cancerRadioactive iodine therapyAnlotinibVascular endothelial growth factor/vas-cular endothelial growth factor receptorClinical benefit
《中国药物评价》 2026 (2)
133-137,5
河南省医学科技攻关项目(LHGJ2021001321)
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