替雷利珠单抗联合GP化疗方案对晚期非小细胞肺癌患者ERCC1、K-ras、PI3K及Akt水平的影响  

Effect of tirelizumab combined with GP chemotherapy on ERCC1,K-ras,PI3K and Akt levels in patients with advanced non-small cell lung cancer

作　　者：陈小燕 洪锦得 洪利兴 彭淑芬 林艺坚 CHEN Xiaoyan;HONG Jinde;HONG Lixing;PENG Shufen;LIN Yijian(Department of Respiratory and Critical Care Medicine,Quanzhou First Hospital,Fujian Province,Quanzhou 362000,China;不详)

机构地区：[1]福建省泉州市第一医院呼吸与危重症医学科,362000 [2]福建中医药大学附属晋江中医院急诊科,福建省晋江市362200

出　　处：《临床合理用药杂志》2024年第19期10-13,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察替雷利珠单抗联合GP化疗方案对晚期非小细胞肺癌(NSCLC)患者核苷酸切除修复交叉互补组1(ERCC1)、Kirsten-Rous肉瘤病毒蛋白基因(K-ras)、磷脂酰肌醇3-激酶(PI3K)及蛋白激酶B(Akt)水平的影响。方法选取2021年6月—2023年8月福建省泉州市第一医院收治的晚期NSCLC患者120例,采用随机数字表法分为单抗组和GP组,各60例。GP组予以GP化疗方案(盐酸吉西他滨+顺铂)治疗,单抗组在GP组基础上加用替雷利珠单抗治疗,3周为1个周期,2组均连续治疗3个周期。比较2组近期疗效,治疗前后血清标记蛋白(ERCC1、K-ras、PI3K、Akt)水平、血清肿瘤标志物[组织人非小细胞肺癌抗原(LTA)、神经元特异性烯醇化酶(NSE)、角蛋白19片段抗原21-1(CYFRA21-1)、鳞状细胞癌抗原(SCC)]水平及不良反应。结果单抗组客观缓解率、疾病控制率分别为70.00%、86.67%,高于GP组的51.67%、71.67%(χ^(2)=4.232,P=0.040;χ^(2)=4.093,P=0.043)。2组治疗3个周期后ERCC1、K-ras、PI3K、Akt、LTA、NSE、CYFRA21-1、SCC水平均较治疗前降低,且单抗组低于GP组(P<0.01);单抗组与GP组不良反应总发生率比较差异无统计学意义(16.67%vs.10.00%,χ^(2)=1.713,P=0.191)。结论在晚期NSCLC患者中联用替雷利珠单抗与GP化疗方案,可增强疗效,进一步改善血清标记蛋白及肿瘤标志物水平,且安全性高。Objective To observe the effect of tirelizumab combined with GP chemotherapy on ERCC1,K-ras,PI3K and Akt levels in patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 120 patients with advanced NSCLC admitted to Quanzhou First Hospital,Fujian from June 2021 to August 2023 were selected and randomly divided into monoclonal antibody group and GP group,with 60 cases in each group.The GP group was treated with GP chemotherapy(gemcitabine hydrochloride+cisplatin),while the monoclonal antibody group was treated with tirelizumab on the basis of the GP group.Three weeks was a cycle,and both groups were treated for three consecutive cycles.The short-term efficacy,the levels of serum marker proteins(ERCC1,K-ras,PI3K,Akt),serum tumor markers(LTA,NSE,CYFRA21-1,SCC)before and after treatment,and adverse reactions were compared between the two groups.Results The objective remission rate and disease control rate in the monoclonal antibody group were 70.00%and 86.67%respectively,which were higher than 51.67%and 71.67%in the GP group(χ^(2)=4.232,P=0.040;χ^(2)=4.093,P=0.043).After 3 cycles of treatment,the levels of ERCC1,K-ras,PI3K,Akt,LTA,NSE,CYFRA21-1 and SCC in the two groups were lower than those before treatment,and the levels in the monoclonal antibody group were lower than those in the GP group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the monoclonal antibody group and the GP group(16.67%vs.10.00%,χ^(2)=1.713,P=0.191).Conclusion The combination of tirelizumab and GP chemotherapy in patients with advanced NSCLC can enhance the curative effect,further improve the levels of serum marker proteins and tumor markers,and has high safety.

关 键 词：晚期非小细胞肺癌 替雷利珠单抗 GP化疗方案 血清标记蛋白 血清肿瘤标志物 

分 类 号：R734.2[医药卫生—肿瘤]