血清PD-1/PD-L1在晚期食管癌患者经白蛋白结合型紫杉醇联合信迪利单抗治疗前后的变化  

Changes in serum PD-1/PD-L1 levels in patients with advanced esophageal cancer before and after treatment with albumin-bound paclitaxel in combination with sindilizumab

作　　者：程晓云[1] 张淑平 CHENG Xiaoyun;ZHANG Shuping(Department of Oncology,The Seventh People's Hospital of Hebei Province/The Second Affiliated Hospital of Hebei College of Traditional Chinese Medicine,Dingzhou 073000,China)

机构地区：[1]河北省第七人民医院-河北中医学院第二附属医院肿瘤科,定州073000

出　　处：《中国临床药学杂志》2023年第2期111-115,共5页Chinese Journal of Clinical Pharmacy

基　　金：河北省中医药管理局2022年度中医药类科研计划课题(编号2022398)。

摘　　要：目的 探讨血清程序性细胞死亡受体1(PD-1)/程序性细胞死亡配体1(PD-L1)在晚期食管癌患者经白蛋白结合型紫杉醇联合信迪利单抗治疗前后的水平变化意义。方法 前瞻性选取2019年1月至2021年1月78例晚期食管癌患者,均采取白蛋白结合型紫杉醇联合信迪利单抗治疗,根据疗效分为疾病缓解组与疾病未缓解组,对比2组治疗前后血清PD-1、PD-L1、肿瘤生物学行为指标[Stathmin、细胞角质蛋白19(Cyfra21-1)、肝细胞生长因子受体(c-met)和可溶性主要组织相容性复合体Ⅰ类相关分子A(s MICA)]变化情况,分析PD-1、PD-L1与肿瘤生物学行为指标及生存预后的关系。结果 疾病缓解组治疗1、2、3个周期后血清PD-1、PDL1、Stathmin、Cyfra21-1、c-met、s MICA均低于疾病未缓解组(P <0.05);治疗前与治疗3个周期后血清PD-1、PD-L1差值与Stathmin、Cyfra21-1、c-met、s MICA差值及疗效呈正相关(P <0.05);KM曲线分析,血清PD-1、PD-L1低差值患者1年生存率分别为64.58%(31/48)和63.64%(28/44),高差值患者分别为85.19%(23/27)、83.87%(26/31),低差值与高差值之间差异有统计学意义(P <0.05)。结论 晚期食管癌接受白蛋白结合型紫杉醇联合信迪利单抗治疗前后血清PD-1、PD-L1变化差值与疗效、肿瘤生物学行为改变显著相关,还对生存预后具有重要影响。AIM To investigate the significance of changes in serum programmed cell death receptor 1(PD-1)/programmed cell death ligand 1(PD-L1) levels in patients with advanced esophageal cancer before and after treatment with albumin-bound paclitaxel in combination with sindilizumab.METHODS From January 2019 to January 2021,78patients with advanced esophageal cancer were prospectively selected,all were treated with albumin-bound paclitaxel combined with sindilizumab,and were divided into disease remission group and disease non-remission group according to the efficacy.The serum PD-1,PD-L1,tumor biological behavior indicators [Stathmin,cytokeratin 19(Cyfra21-1),hepatocyte growth factor receptor(c-met),soluble major histocompatibility] before and after treatment between the 2 groups were compared.The relationship between PD-1,PD-L1 and tumor biological behavior indicators and survival prognosis was analyzed.RESULTS The serum PD-1,PD-L1,Stathmin,Cyfra21-1,c-met,and sMICA in the disease remission group were lower than those in the disease non-remission group after 1 cycle,2 cycles,and 3 cycles of treatment(P<0.05);serum PD-1 and PD-L1 differences before treatment and after 3 cycles of treatment were positively correlated with Stathmin,Cyfra21-1,c-met,and sMICA.Cyfra21-1,c-met,sMICA differences and efficacy were positively correlated(P<0.05);KM curve analysis showed that 1-year survival rates of 64.58%(31/48) and 63.64%(28/44) in patients with low differentials of serum PD-1 and PD-L1 were lower than those of 85.19%(23/27) and 83.87%(26/31) in patients with high differentials(P<0.05).CONCLUSION The difference in serum PD-1 and PD-L1 changes before and after treatment with albumin-bound paclitaxel combined with sindilizumab in advanced esophageal cancer is significantly associated with efficacy and altered tumor biological behavior,and also has an important impact on survival prognosis.

关 键 词：晚期食管癌 白蛋白结合型紫杉醇 信迪利单抗 程序性细胞死亡受体1 程序性细胞死亡配体1 肿瘤生物学行为 

分 类 号：R735.1[医药卫生—肿瘤]