PD-1抑制剂在不可切除局部进展期食管鳞癌治疗中的效果及安全性分析  

Analysis of efficacy and safety of PD-1 inhibitors in treatment of unresectable locally advanced esophageal squamous cell carcinoma

作　　者：张殿宝[1] 康议心[1] 张策 ZHANG Dian-bao;KANG Yi-xin;ZHANG Ce(Department of Oncology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471003,China)

机构地区：[1]河南科技大学第一附属医院肿瘤内科,河南洛阳471003

出　　处：《医药论坛杂志》2022年第2期1-5,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划项目(LHGJ20200578)。

摘　　要：目的分析程序性死亡受体-1(programmed death receptor-1,PD-1)抑制剂在不可切除局部进展期食管鳞癌治疗中的效果及安全性。方法选择2020年1月—2021年6月河南科技大学第一附属医院收治的50例食管鳞癌患者,根据就诊顺序,分为研究组和对照组各25例。对照组接受基础化疗治疗,在此基础上,研究组加用PD-1抑制剂辅助治疗。治疗前、治疗8周后,比较两组T淋巴细胞亚群,包括CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+);肠道菌群数量,包括双歧杆菌、大肠杆菌、乳酸杆菌及肠道菌群定植抗力(CR);血清肿瘤标志物,包括细胞间粘附分子-3(ICAM-3)蛋白分子量、癌胚抗原(CEA)、血清组织蛋白酶X(SC-X)。同时比较疗效及安全性。结果治疗8周后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、大肠杆菌数、ICAM-3、CEA、SC-X均下降,且研究组比对照组低,差异有统计学意义(P<0.05);两组CD8^(+)、双歧杆菌数、乳酸杆菌数、CR均上升,且研究组比对照组高,差异有统计学意义(P<0.05);研究组ORR(48.00%)、DCR(68.00%)均比对照组(24.00%、40.00%)略高,其中,两组ORR相比,差异无统计学意义(P>0.05);两组DCR相比,差异有统计学意义(P<0.05);治疗1周、治疗4周、治疗8周,研究组的ECOG分级评分均比对照组低,差异有统计学意义(P<0.05)。结论 PD-1抑制剂应用于不可切除局部进展期食管鳞癌的临床治疗,可改善机体免疫功能,调节肠道菌群数量,还可降低血清肿瘤标志物水平,且不会大幅增加药物不良反应,安全性高。Objective To analyze the efficacy and safety of programmed death receptor-1(PD-1) inhibitors in the treatment of unresectable locally advanced esophageal squamous cell carcinoma.Methods Selected 50 patients with esophageal squamous cell carcinoma admitted to our hospital from January 2020 to June 2021.According to the order of treatment,they were divided into study group and control group with 25 cases each.The control group received basic chemotherapy treatment,and on this basis,the study group received adjuvant therapy with PD-1 inhibitors.Before treatment and after 8 weeks of treatment,compared the two groups of T lymphocyte subsets,including CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+);The number of intestinal flora,including Bifidobacterium,Escherichia coli,Lactobacillus and colonization of intestinal flora Resistance(CR);Serum tumor markers,including intercellular adhesion molecule-3(ICAM-3) protein molecular weight,carcinoembryonic antigen(CEA),serum cathepsin X(SC-X).At the same time compared the efficacy and safety.Results After 8 weeks of treatment,the two groups of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),the number of Escherichia coli,ICAM-3,CEA,SC-X decreased in the study group were lower than those the control group,the differences were statistically significant(P<0.05);CD8^(+),Bifidobacterium count,Lactobacillus count,CR increased in the two groups,and the study group was higher than that of the control group,the difference was statistically significant(P<0.05);The study group ORR(48.00%),DCR(68.00%) were slightly higher than those of the control group(24.00%,40.00%).Among them,there was no statistically significant difference in ORR between the two groups(P>0.05);The difference between the two groups in DCR was statistically significant(P<0.05);Treatment for 1 week,4 weeks of treatment,and 8 weeks of treatment,the ECOG grading scores of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion PD-1 inhibitors used in the clinical treatment of

关 键 词：食管鳞癌 局部进展期 PD-1抑制剂 免疫功能 肠道菌群 

分 类 号：R735.1[医药卫生—肿瘤]