信迪利单抗辅助治疗晚期NSCLC患者的疗效及对免疫功能水平的影响OACSTPCD
Efficacy of Sintilimab in Adjuvant Treatment of Patients with Advanced NSCLC and its Influence on Immune Func-tion
目的 探讨信迪利单抗辅助治疗晚期非小细胞肺癌(NSCLC)的疗效以及对免疫功能水平的影响.方法 选取2020 年3 月至2023 年3 月我院收治的晚期NSCLC患者98 例,随机数字表法分为两组,各49 例.对照组给予AP方案化疗,观察组在对照组基础上联合信迪利单抗治疗.比较两组疗效、肿瘤标志物(CEA、CA125)水平变化,以及治疗前后免疫功能水平差异,记录两组治疗期间不良反应发生情况.结果 观察组患者相较于对照组疗效整体情况更优(Z =-2.327,P＜0.05);观察组与对照组 ORR(34.69%vs.22.45%)比较差异无统计学意义(P＞0.05),但观察组 DCR(71.43%vs.46.94%)高于对照组(P＜0.05).两组T2～T4 CEA、CA125 水平相较于T1 均有不同程度下降(P＜0.05);两组CEA、CA125 水平T1 时比较差异无统计学意义(P＞0.05);T2～T4,观察组 CEA、CA125 水平均低于对照组(P＜0.05).治疗前,两组CD3 +、CD4 +、CD4 +/CD8 +以及NK细胞水平比较差异无统计学意义(P＞0.05),观察组治疗后CD3 +(67.56±9.55 vs.63.01±9.86)、CD4 +(37.95±6.71 vs.31.89±7.15)、CD4 +/CD8 +(1.72±0.51 vs.1.41±0.39)以及NK细胞(27.35±6.11 vs.22.89±5.73)水平均高于对照组,差异有统计学意义(P＜0.05).观察组与对照组两组骨髓抑制(63.27%vs.57.14%)、胃肠道反应(73.47%vs.69.39%)、肝功能异常(30.61%vs.24.49%)发生率比较差异无统计学意义(P＞0.05),观察组甲状腺功能减退发生率(20.41%vs.6.12%)高于对照组(P＜0.05).结论 信迪利单抗辅助AP方案治疗晚期NSCLC疗效确切,能够提高肿瘤控制率,降低肿瘤标志物水平,调节机体免疫功能,具有一定安全性,但可能增加甲状腺功能减退风险.
Objective To investigate the efficacy of sintilimab in adjuvant treatment of advanced non-small cell lung cancer(NSCLC)and its influence on immune function.Methods 98 patients with advanced NSCLC admitted to our hospital from March 2020 to March 2023 were selected and divided into two groups based on a random number table method,with 49 patients in both groups.The control group was treated with AP chemotherapy,and the observation group was treated with sintilimab on the ba-sis of the control group.The curative effect and the changes of tumor markers(CEA,CA125)were compared between the two groups.The differences of immune function between the two groups before and after treatment were compared,and the incidence of adverse reactions during treatment was recorded.Results Compared with the control group,the overall efficacy of the observation group patients was better(Z =-2.327,P＜0.05);There was no significant difference in ORR between the observation group and the control group(34.69%vs.22.45%)(P＞0.05),but the DCR of the observation group(71.43%vs.46.94%)was higher than that of the control group(P＜0.05).The levels of T2～T4 CEA and CA125 in both groups decreased to varying degrees com-pared to T1(P＜0.05);There was no difference in the levels of CEA and CA125 between the two groups at T1(P＞0.05),and at T2～T4,the levels of CEA and CA125 in the observation group were lower than those in the control group(P＜0.05).Before treat-ment,there was no difference in the levels of CD3 +,CD4 +,CD4 +/CD8 +,and NK cells between the two groups(P＞0.05).After treatment,the levels of CD3 +(67.56±9.55 vs.63.01±9.86),CD4 +(37.95±6.71 vs.31.89±7.15),CD4 +/CD8 +(1.72±.51 vs.1.41±0.39),and NK cells(27.35±6.11 vs.22.89±5.73)in the observation group were higher than those in the con-0 trol group,with statistical significance(P＜0.05).There was no difference in the incidence of bone marrow suppression(63.27%vs.57.14%),gastrointestinal reaction(73.47%vs.69.39%),and liver dysfunction(30.61%vs.24.49%)between the observa-tion group and the control group(P＞0.05).The incidence of hypothyroidism in the observation group(20.41%vs.6.12%)was higher than that in the control group(P＜0.05).Conclusion Sintilimab combined with AP regimen is effective in the treatment of advanced NSCLC,which can improve the tumor control rate,reduce the level of tumor markers,and regulate the level of immune function.It is safe,but it may increase the risk of hypothyroidism.
刘梦;蔡婧;李景攀
成都市中西医结合医院,四川 成都 610000
药学
晚期非小细胞肺癌信迪利单抗疗效T细胞亚群安全性
advanced non-small cell lung cancersintilimabefficacyT cell subsetssecurity
《四川医学》 2024 (003)
280-285 / 6
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