放疗联合免疫治疗复发性食管癌的疗效及对T淋巴细胞、肿瘤标志物的影响  

Efficacy of radiotherapy combined with pabrizumab in the treatment of recurrent esophageal cancer and its effect on T lymphocytes and tumor markers

作　　者：潘广鹏 田嘉安 刘燕[1] 张鑫 陆艳荣[1] Pan Guangpeng;Tian Jia'an;Liu Yan;Zhang Xin;Lu Yanrong(Department of Thoracic and Abdominal Radiotherapy,Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属肿瘤医院胸腹放疗科,乌鲁木齐830000

出　　处：《疑难病杂志》2024年第7期779-783,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金资助项目(2022D01C300)。

摘　　要：目的探讨放疗联合免疫治疗复发性食管癌的疗效及对T淋巴细胞、肿瘤标志物的影响。方法选取2020年9月—2023年9月新疆医科大学附属肿瘤医院胸腹放疗科采用三维适形调强放疗(IMRT)联合卡瑞利珠单抗治疗的复发性食管癌患者33例纳入观察组,另选取同期医院行单纯性IMRT的复发性食管癌患者33例纳入对照组。2组均治疗6周后评估患者临床疗效;于治疗前、治疗6周后比较2组T淋巴细胞亚群[CD3细胞(CD3^(+))、CD4细胞(CD4^(+))、CD8细胞(CD8^(+))]、肿瘤增殖相关因子[血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、转录因子阴阳1(YY1)]、肿瘤标志物[糖类抗原125(CA125)、癌胚抗原(CEA)、鳞状细胞癌抗原(SCC)];记录并比较2组治疗期间不良反应发生情况。结果观察组总有效率高于对照组(96.97%vs.75.76%,χ^(2)/P=4.632/0.031);治疗6周后,2组CD3^(+)、CD4^(+)高于治疗前,CD8^(+)低于治疗前,且观察组高于/低于对照组(t/P=4.598/<0.001,3.317/<0.001,4.664/<0.001);治疗6周后,2组血清VEGF、MMP-9、YY1、CA125、CEA、SCC低于治疗前,且观察组低于对照组(t/P=7.229/<0.001,6.388/<0.001,6.157/<0.001,5.322/<0.001,5.116/<0.001,2.479/0.016);治疗期间,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论放疗联合免疫治疗能更有效地降低血清肿瘤增殖相关因子及肿瘤标志物水平,提高临床疗效,改善患者免疫功能,且不会显著增加不良反应发生风险。Objective To investigate the efficacy of radiotherapy combined with Paporizumab in the treatment of recurrent esophageal cancer and its effect on T lymphocytes and tumor markers.Methods Thirty-three patients with recurrent esophageal cancer who underwent three-dimensional conformal intensity-modulated radiotherapy(IMRT)in the Department of Thoracic and Abdominal Radiotherapy,Affiliated Tumor Hospital of Xinjiang Medical University from September 2020 to September 2023 were selected as the control group,and 33 patients with recurrent esophageal cancer who underwent IMRT combined with carrelizumab in the same period were selected as the observation group.Both groups were treated for 6 weeks,and then the clinical efficacy of the patients was evaluated.Both groups were treated for 6 weeks,and the clinical efficacy of the patients was evaluated at 6 weeks of treatment.T lymphocyte subsets[CD3 cells(CD3^(+)),CD4 cells(CD4^(+)),CD8 cells(CD8^(+))],tumor proliferation-related factors[vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9),transcription factor Yin and Yang 1(YY1)],tumor markers[carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC)]were compared between the two groups before treatment and 6 weeks after treatment.The occurrence of toxic and side effects during treatment was recorded and compared between the two groups.Results After treatment,the total effective rate of the observation group[96.97%(32/33)]was higher than that of the control group[75.76%(25/33)](χ^(2)/P=4.632/0.031).After treatment,VEGF,MMP-9,YY1,CA125,CEA and SCC in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(t/P=4.598/<0.001,3.317/<0.001,4.664/<0.001).After treatment,CD8^(+)was lower than that in the control group,CD3^(+)and CD4^(+)in the observation group were significantly higher than those in the control group(χ^(2)/t/P=7.229/<0.001,6.388/<0.001,6.157/<0.001,5.322/<0.001,5.116/<0.001,2.

关 键 词：复发性食管癌 放疗 卡瑞利珠单抗 T淋巴细胞 肿瘤标志物 疗效 

分 类 号：R735.1[医药卫生—肿瘤]