PD-1/PD-L1抑制剂治疗复发或转移性宫颈癌的疗效及对患者血清SCC-Ag、CEA及CA125水平的影响  

Efficacy of PD-1/PD-L1 inhibitors for recurrent or metastatic cervical cancer and its effect on serum levels of SCC-Ag,CEA,and CA125

作　　者：吴芳萍 陈纪武 周伟弢 赵楚楚 Wu Fangping;Chen Jiwu;Zhou Weitao;Zhao Chuchu(Department of Obstetrics and Gynecology,Lishui Municipal Central Hospital,Lishui 323000,Zhejiang Province,China)

机构地区：[1]丽水市中心医院妇产科,丽水323000

出　　处：《中国基层医药》2024年第6期817-823,共7页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医药卫生科技计划(2021KY1243)。

摘　　要：目的探讨程序性死亡受体1(PD-1)/程序性死亡配体1(PD-L1)抑制剂治疗复发或转移性宫颈癌的疗效及对患者血清鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)及糖类抗原125(CA125)水平的影响。方法该研究为回顾性研究,选取丽水市中心医院2019年1月至2022年12月收治的宫颈癌患者90例为研究对象,根据治疗方式不同分组,对照组45例行常规放化疗,观察组45例在对照组基础上加以PD-1/PD-L1抑制剂治疗,观察两种治疗方案的疗效和安全性。结果观察组疗效优于对照组(P<0.05);治疗后观察组SCC-Ag、CA125及CEA及人附睾蛋白4(HE4)均低于对照组,差异均有统计学意义(t=5.44、6.20、14.74、4.06,均P<0.001);治疗后观察组干扰素γ(INF-γ)、白细胞介素2(IL-2)和白细胞介素6(IL-6)均低于对照组,差异均有统计学意义(t=6.24、8.95、8.38,均P<0.001);治疗后观察组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(t=8.82、6.53、5.27,均P<0.001);治疗后观察组宫颈癌生存质量评估量表(FACT-Cx)评分均高于对照组,差异均有统计学意义(t=4.35、4.35、5.17、5.24,均P<0.001);治疗后观察组患者各类不良反应发生率均低于对照组(χ^(2)=3.85、3.87、5.08、4.44,均P<0.05);观察组累积生存率高于对照组[60.00%(27/45)比40.00%(18/45)],中位生存时间长于对照组(365 d比222 d),差异均有统计学意义(均P<0.05)。结论PD-1/PD-L1抑制剂治疗复发或转移性宫颈癌的疗效确切,可以降低患者血清SCC-Ag、CEA及CA125水平,延长患者生存时间,提高生活质量。Objective To investigate the efficacy of programmed death receptor-1(PD-1)/programmed death-ligand 1(PD-L1)inhibitors in the treatment of recurrent or metastatic cervical cancer and its effect on serum levels of squamous cell carcinoma antigen(SCC-Ag),carcinoembryonic antigen(CEA),and carbohydrate antigen 125(CA125)in patients.Methods This study was a retrospective study.Ninety patients with cervical cancer treated at Lishui Municipal Central Hospital between January 2019 and December 2022 were randomly divided into two groups.Forty-five patients in the control group received routine radiotherapy and chemotherapy,while forty-five patients in the observation group received PD-1/PD-L1 inhibitors in addition to the treatment provided to the control group.The effectiveness and safety were compared between the two groups.Results The effectiveness in the observation group was superior to that in the control group(P<0.05).After treatment,the levels of serum tumor markers,including SCC-Ag,CA125,CEA,and human epididymal protein 4,were significantly lower in the observation group compared with the control group(t=5.44,6.20,14.74,4.06,all P<0.001).After treatment,the levels of interferon-γ,interleukin-2,and interleukin-6 in the observation group were significantly lower compared with the control group(t=6.24,8.95,8.38,all P<0.001).After treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the observation group were significantly higher compared with those in the control group(t=8.82,6.53,5.27,all P<0.001).After treatment,the Functional Assessment of Cancer Therapy-Cervix score in the observation group was significantly higher than that in the control group(t=4.35,4.35,5.17,5.24,all P<0.001).The incidence of various adverse reactions in the observation group was significantly lower than that in the control group(χ^(2)=3.85,3.87,5.08,4.44,all P<0.05).The cumulative survival rate in the observation group was significantly higher than that in the control group[60.00%(27/45)vs.40.00%(18/45),P<0.05].The median survival

关 键 词：宫颈肿瘤 生物标记 肿瘤 免疫 生活质量 药物相关性副作用和不良反应 

分 类 号：R737.33[医药卫生—肿瘤]