王莉　　张建勇

[摘要] 目的 提高重组人血管内皮抑制素注射液治疗间变性淋巴瘤激酶（ALK）融合肺腺癌并心包转移的认识。 方法 分析遵义医科大学附属医院2017—2018年收治的2例肺腺癌并心包转移的患者，以“肺腺癌、重组人血管内皮抑制素注射液、心包转移”为检索词检索中国生物医学文献服务系统（SINOMED）、万方医学数据库及维普信息资源系统，以“Adenocarcinoma、Pericardial metastasis、Recombinant human endostatin injection”为检索词检索Pubmed检索系统，并结合检索文献进行分析。 结果 2例患者均为中青年，第1例为化疗后2+年病情进展，使用抗血管生成药物恩度心包腔内注射后心包积液吸收，效果明显;第2例为诊断肺腺癌后服用克唑替尼治疗，出现心包积液，考虑疾病进展，予心包腔内注射药物恩度，心包积液有所吸收，但病情反复，效果差，现已去世。检索国内外相关文献，国内文献40余篇，外文文献70余篇。总结国内外文献，对腔内注射药物治疗相关报道较多，双药联合治疗较单药治疗疗效更好，但双药联合治疗副作用较单药多，因此临床上对于腔内注射药物的选择根据患者病情制订个体化的方案。 结论 肺腺癌并心包积液治疗主要以治疗原发病为主，恩度腔内治疗效果不一，仍需进一步研究探讨其可能机制。

[关键词] ALK融合;肺腺癌;重组人血管内皮抑制素注射液;心包转移

[中图分类号] R733          [文献标识码] C          [文章編号] 1673-9701（2021）13-0148-03

Experiences and literature review of recombinant human endostatin injection in treating two cases of ALK-fusion lung adenocarcinoma with pericardial metastasis

WANG Li   ZHANG Jianyong

Ward Ⅱ， Department of Respiratory and Critical Care Medicine， the Affiliated Hospital of Zunyi Medical University， Zunyi   563000， China

[Abstract] Objective To improve the understanding of recombinant human endostatin injection in the treatment of patients with anaplastic lymphoma kinase（ALK）-fusion lung adenocarcinoma and pericardial metastasis. Methods Two patients with lung adenocarcinoma and pericardial metastasis from 2017 to 2018 in the Affiliated Hospital of Zunyi Medical University were analyzed. The Chinese Biomedical Literature Service System（SINOMED）， Wanfang Medical Database and VIP Information Resource System were searched with "lung adenocarcinoma， pericardial metastasis， recombinant human endostatin injection" as the key words， and Pubmed Retrieval System was searched with “adenocarcinoma， pericardial metastasis， endostar” as the key words. The analysis was made with the retrieved literatures. Results The two patients were young and middle-aged. As for the first case， two years after chemotherapy， pericardial effusion was absorbed after anti-angiogenic drug endostar injection into pericardial cavity， with obvious effect. The second case was treated with crizotinib after diagnosis of lung adenocarcinoma. Pericardial effusion occurred. Considering the progress of the disease， endostar was injected into the pericardial cavity. Pericardial effusion was absorbed， yet with relapse of illness and poor effect. This case died. Relevant literatures at home and abroad were retrieved and summarized. There were many reports on intracavitary drug injection. Double-drug combination therapy has a better curative effect than single-drug therapy， but double-drug combination therapy has more side effects than single-drug therapy. Therefore， clinically， the selection of intracavitary drug injection should be individualized according to the patients condition. Conclusion The lung adenocarcinoma complicated with pericardial effusion is mainly treated as the primary disease， and endostar shows different therapeutic effects in cavity. Further research is still needed to explore its possible mechanism.

[Key words] ALK fusion; Lung adenocarcinoma; Recombinant human endostatin injection; Pericardial metastasis

肺癌已成为全球范围内最常见的恶性肿瘤，其发病率及死亡率呈逐年上升趋势，成为死亡率極高的疾病[1-4]。肺腺癌是肺癌中常见的病理类型，晚期易合并心包积液，出现心包填塞和心力衰竭，影响患者的呼吸、循环功能。……