派安普利单抗联合化疗对晚期非小细胞肺癌患者血管生成及循环内皮细胞的影响  

Impact of pembrolizumab combined with chemotherapy on angiogenesis and circulating endothelial cells in patients with advanced non-small cell lung cancer

作　　者：姜溪[1] 武永存[1] 梁艳[1] 楚丽[1] 段颖欣 王力军[1] 霍俊杰[1] Jiang Xi;Wu Yongcun;Liang Yan;Chu Li;Duan Yingxin;Wang Lijun;Huo Junjie(Department of Chemoradiotherapy,Second Affiliated Hospital of Xingtai Medical College,Xingtai 054000,China)

机构地区：[1]邢台医学高等专科学校第二附属医院放化疗科,邢台054000

出　　处：《国际肿瘤学杂志》2024年第2期89-94,共6页Journal of International Oncology

基　　金：邢台市科技局重点研发计划(2021ZC172)。

摘　　要：目的探讨派安普利单抗联合化疗对晚期非小细胞肺癌(NSCLC)患者血管生成及循环内皮细胞的影响。方法收集2021年8月至2023年1月邢台医学高等专科学校第二附属医院收治的121例晚期NSCLC患者的临床资料,根据治疗方案将患者分成对照组(n=57)和观察组(n=64),对照组患者行常规化疗(顺铂+紫杉醇),观察组患者在常规化疗的基础上加用派安普利单抗治疗。比较两组患者近期临床疗效、生命质量、免疫功能指标、血管生成因子[内皮抑素、胰岛素样生长因子1(IGF-1)和血管内皮生长因子(VEGF)]、循环内皮细胞及不良反应等参数。结果治疗6个周期后,观察组患者客观缓解率[67.19%(43/64)比49.12%(28/57)]、疾病控制率[87.50%(56/64)比70.18%(40/57)]均高于对照组,差异均有统计学意义(χ^(2)=4.06,P=0.044;χ^(2)=5.52,P=0.019)。观察组患者生命质量评分[(56.77±6.81)分]明显高于对照组[(47.73±8.23)分],差异有统计学意义(t=6.61,P<0.001);观察组患者T细胞亚群CD3^(+)水平[(63.59±9.00)%比(53.06±8.80)%,t=6.49,P<0.001]、CD4^(+)水平[(46.54±8.20)%比(30.74±7.32)%,t=11.13,P<0.001]和CD4^(+)/CD8^(+)比值(1.90±0.36比1.21±0.28,t=11.66,P<0.001)明显高于对照组,差异均有统计学意义;观察组患者内皮抑素[(48.99±3.43)μmol/L]明显高于对照组[(31.35±3.87)μmol/L],差异有统计学意义(t=26.58,P<0.001),IGF-1[(102.31±20.35)μg/L比(134.98±19.02)μg/L]和VEGF[(31.70±4.32)pg/ml比(58.71±5.99)pg/ml]明显低于对照组,差异有统计学意义(t=18.73,P<0.001;t=28.14,P<0.001)。观察组患者循环内皮细胞数[(58.77±10.03)个/ml]明显低于对照组[(87.01±8.01)个/ml],差异有统计学意义(t=17.20,P<0.001)。治疗期间,两组患者胃肠道反应(χ^(2)=0.01,P=0.908)、白细胞减少(χ^(2)=0.64,P=0.424)、血小板减少(χ^(2)=0.28,P=0.597)、贫血(χ^(2)=1.66,P=0.197)、肾毒性(χ^(2)=0.64,P=0.424)、皮疹(χ^(2)=1.33,P=0.249)不良反应发生率差异均无统计学意义。结�Objective To explore the impact of pembrolizumab combined with chemotherapy on angiogenesis and circulating endothelial cells in patients with advanced non-small cell lung cancer(NSCLC).Methods The retrospective analysis of clinical data from 121 patients diagnosed with advanced NSCLC who were admitted to the Second Affiliated Hospital of Xingtai Medical College from August 2021 to January 2023 was conducted.These patients were divided into a control group(n=57)and an observation group(n=64)based on the designated treatment protocol.Specifically,individuals in the control group received standard chemotherapy(cisplatin+paclitaxel),while those in the observation group underwent penpilimab therapy in conjunction with conventional chemotherapy.The comparative assessment encompassed short-term clinical efficacy,quality of life,immune function parameters,angiogenic factors[including endostatin,insulin-like growth factor 1(IGF-1),and vascular endothelial growth factor(VEGF)],circulating endothelial cells,and adverse reactions within the two groups.Results After 6 courses of treatment,the objective response rate[67.19%(43/64)vs.49.12%(28/57)]and disease control rate[87.50%(56/64)vs.70.18%(40/57)]in observation group were higher than those in control group,with statistically significant differences(χ^(2)=4.06,P=0.044;χ^(2)=5.52,P=0.019).The quality of life score of observation group[(56.77±6.81)points]was significantly higher than that of control group[(47.73±8.23)points],with a statistically significant difference(t=6.61,P<0.001);The T cell subgroup CD3^(+)levels[(63.59±9.00)%vs.(53.06±8.80%),t=6.49,P<0.001],CD4^(+)levels[(46.54±8.20)%vs.(30.74±7.32)%,t=11.13,P<0.001]and CD4^(+)/CD8^(+)ratio(1.90±0.36 vs.1.21±0.28,t=11.66,P<0.001)in observation group were significantly higher than those in control group,with statistically significant differences;Endostatin in observation group[(48.99±3.43)μmol/L]was significantly higher than that in control group[(31.35±3.87)μmol/L],with a statistically significant differen

关 键 词：癌 非小细胞肺 抗肿瘤联合化疗方案 血管内皮生成因子类 循环内皮细胞 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤]