信迪利单抗联合白蛋白紫杉醇对晚期胃癌血清肿瘤标志物水平及免疫功能的影响  

Effect of sintilimab combined with albumin paclitaxel on serum tumor marker levels and immune function in advanced gastric cancer

作　　者：李璐璐[1] 黄然欣[1] 张蓉[1] 张瑛[1] 周文雅[1] 秦泽敏 于俊岩[1] LI Lu-lu;HUANG Ran-Xin;ZHANG Rong(Department of Oncology,Heping Hospital Affiliated to Changzhi Medical College,Changzhi Shanxi 046000,China)

机构地区：[1]长治医学院附属和平医院肿瘤科,山西长治046000

出　　处：《临床和实验医学杂志》2023年第22期2384-2387,共4页Journal of Clinical and Experimental Medicine

基　　金：山西省科技厅自然科学基金项目(编号:201801D121309)。

摘　　要：目的探究信迪利单抗联合白蛋白紫杉醇对晚期胃癌血清肿瘤标志物水平及免疫功能的影响。方法前瞻性选取2021年6月至2023年2月在长治医学院附属和平医院接受治疗的89例晚期胃癌患者为研究对象,按照随机数字表法分为对照组(n=44)和观察组(n=45)。对照组患者采取白蛋白紫杉醇治疗,观察组患者采取信迪利单抗联合白蛋白紫杉醇进行治疗。比较两组治疗效果、肿瘤标志物[糖类抗原(CA)125、CA19-9、癌胚抗原、甲胎蛋白及组织多肽特异性抗原(TPS)]水平、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,记录患者治疗期间发生的不良反应。结果治疗后,观察组患者的客观缓解率及疾病控制率分别为55.56%、77.78%,均高于对照组(34.09%、47.73%),差异均有统计学意义(P<0.05)。治疗后,两组患者的各肿瘤标志物水平均较治疗前降低,且观察组CA125、CA19-9、癌胚抗原、甲胎蛋白、TPS水平分别为(16.77±2.77)U/mL、(15.33±3.44)U/mL、(1.22±0.21)U/mL、(14.13±2.87)μg/L、(22.78±4.26)U/L,均低于对照组[(22.31±3.33)U/mL、(24.65±4.32)U/mL、(3.88±0.66)U/mL、(23.87±3.45)μg/L、(32.15±5.67)U/L],差异均有统计学意义(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)值均较治疗前升高,CD8^(+)水平较治疗前降低,且观察组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)值分别为(69.55±4.15)%、(42.26±4.54)%、2.01±0.15,均高于对照组[(60.34±3.44)%、(32.48±3.56)%、1.48±0.41],CD8^(+)水平为(21.06±2.09)%,低于对照组[(22.45±2.12)%],差异均有统计学意义(P<0.05)。两组不良反应发生方面比较,差异无统计学意义(P>0.05)。结论对晚期胃癌患者采用信迪利单抗联合白蛋白紫杉醇治疗,治疗效果显著,患者血清肿瘤标志物水平得到显著降低,免疫功能改善显著,且具有较好的安全性。Objective To explore the effect of sintilimab combined with albumin paclitaxel on serum tumor marker levels and immune function in advanced gastric cancer.Methods A prospective study was conducted on 89 patients with advanced gastric cancer who were treated at Heping Hospital Affiliated to Changzhi Medical College from June 2021 to February 2023.They were divided into the control group(n=44)and the observation group(n=45)according to the random number table method.The control group were treated with nab paclitaxel,and the observation group were treated with sintilimab combined with albumin paclitaxel.The efficacy,levels of tumor markers[carbohydrate antigen(CA)125,CA19-9,carcinoembryonic antigen,alpha fetoprotein,and tissue peptide specific antigen(TPS)],and levels of immune function indicators(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were compared between the two groups,and adverse reactions occurred during treatment were recorded.Results The proportion of objective response rate and disease control rate of the observation group were 55.56%,77.78%,which were higher than those of the control group(34.09%,47.73%),the differences were statistically significant(P<0.05).After treatment,the levels of various tumor markers in two groups were lower than those before treatment,and the levels of CA125,CA19-9,carcinoembryonic antigen,alpha fetoprotein,and TPS in the observation group were(16.77±2.77)U/mL,(15.33±3.44)U/mL,(1.22±0.21)U/mL,and(14.13±2.87)μg/L and(22.78±4.26)U/L,respectively,which were lower than those in the control group[(22.31±3.33)U/mL,(24.65±4.32)U/mL,(3.88±0.66)U/mL,(23.87±3.45)μg/L,(32.15±5.67)U/L],the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in two groups were higher than those before treatment,while the levels of CD8^(+)was lower than those before treatment,and the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the observation group were(69.55±4.15)%,(42.26±4.54)%,and 2.01±0.15,respectively,which were higher than

关 键 词：胃肿瘤 信迪利单抗 白蛋白紫杉醇 晚期胃癌 肿瘤标志物 免疫功能 

分 类 号：R735.2[医药卫生—肿瘤]