综合治疗对局部晚期鼻咽癌的疗效及对外周血PD-1、sE-cad和免疫功能的影响  

The efficacy of comprehensive treatment for locally advanced nasopharyngeal carcinoma and its impact on peripheral blood PD⁃1,sE⁃cad and immune function

作　　者：刘新菊 刘冬梅 邱荣良 LIU Xinju;LIU Dongmei;QIU Rongliang(The Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital,Zhengzhou,Henan,China,450008)

机构地区：[1]郑州大学附属肿瘤医院(河南省肿瘤医院),河南郑州450008

出　　处：《分子诊断与治疗杂志》2024年第4期661-664,669,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省科技攻关项目(202102310114)。

摘　　要：目的探讨综合治疗对局部晚期鼻咽癌的临床疗效以及对外周血程序性死亡因子-1(PD-1)、上皮型钙黏蛋白(s E-cad)和免疫功能的影响。方法选取2021年1月至2023年6月河南省肿瘤医院放疗科收治的175例局部晚期鼻咽癌患者,按不同疗法分为综合组100例和对照组75例,对照组以同步放化疗标准治疗为主,综合组在对照组基础上联合免疫治疗。比较两组肿瘤退缩率、不良反应发生率及疗效差异,比较两组治疗前后外周血PD-1、s E-cad和免疫指标[B细胞、NK细胞、T细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)CD28^(+)及CD4^(+)/CD8^(+))]变化。结果综合组客观缓解率、疾病控制率和肿瘤退缩率≥50%患者所占比例均高于对照组,不良反应总发生率低于对照组,差异均有统计学意义(P<0.05);治疗后综合组外周血PD-1水平较对照组明显上升、s E-cad水平明显下降,差异有统计学意义(P<0.05);治疗后综合组B细胞表达率降低,NK细胞、T细胞亚群表达率上升,对照组CD3^(+)表达率上升,B细胞、NK细胞、CD4^(+)、CD8^(+)CD28^(+)表达率及CD4^(+)/CD8^(+)下降,两组免疫指标变化情况比较差异均有统计学意义(P<0.05)。结论应用综合治疗局部晚期鼻咽癌患者的疗效确切,可降低患者外周血PD-1、s E-cad水平,有助于改善机体免疫功能,延缓肿瘤进展,安全性较高。Objective To investigate the clinical effect of combined therapy on locally advanced nasopharyngeal carcinoma and the effects on peripheral blood programmed death factor⁃1(PD⁃1),epithelial cadherin(sE⁃cad)and immune function.Methods 175 patients with locally advanced nasopharyngeal carcino⁃ma were admitted to the Radiotherapy Department of Henan Cancer Hospital from January 2021 to June 2023.They were selected and divided into a comprehensive group(100 cases)and a control group(75 cases)based on different therapies.The control group received standard chemoradiotherapy,and the comprehensive group re⁃ceived immunotherapy in addition to the standard treatment.The tumor regression rate,incidence of adverse re⁃actions and overall efficacy were compared between the two groups.Additionally,changes in peripheral blood PD⁃1,sE⁃cad and immune indexes(including B cells,NK cells,and T cell subsets such as CD3^(+),CD4^(+),CD8^(+)CD28^(+)and CD4^(+)/CD8^(+))before and after treatment were analyzed for both groups.Results The proportion of patients with an objective remission rate,disease control rate and tumor regression rate≥50%in the comprehen⁃sive group was higher than that in the control group.Additionally,the total incidence of adverse reactions was lower in the comprehensive group compared to the control group,with statistical significance(P<0.05).After treatment,the level of PD⁃1 in peripheral blood of the comprehensive group was significantly higher than that of the control group,while the level of sE⁃cad was significantly lower,showing statistical significance(P<0.05).Furthermore,the expression rate of B cells decreased in the comprehensive group,while the expression rate of NK cells and T cell subsets increased.In contrast,the expression rate of CD3^(+)increased in the control group,and the expression rate of B cells,NK cells,CD4^(+),CD8^(+)CD28^(+)and CD4^(+)/CD8^(+)decreased in the control group.There were statistically significant differences in the changes of immune indicators between the

关 键 词：同步放化疗 鼻咽癌 PD-1 SE-CAD 

分 类 号：R739.63[医药卫生—肿瘤]