术前新辅助化疗联合免疫疗法对食管癌胸腔镜手术患者的临床疗效观察  

Clinical Efficacy Observation of Neoadjuvant Chemotherapy Combined with Immunotherapy in Esophageal Cancer Patients Undergoing Thoracoscopic Surgery

作　　者：王立君 WANG Lijun(Department of Thoracic and Cardiovascular Surgery,Xun County People's Hospital,Hebi Henan 456250,China)

机构地区：[1]浚县人民医院胸心外科,河南鹤壁456250

出　　处：《临床研究》2025年第1期91-94,共4页Clinical Research

摘　　要：目的分析实施术前新辅助化疗联合免疫疗法对接受胸腔镜手术的食管癌患者的影响。方法根据相关标准纳入浚县人民医院2022年9月13日至2024年5月28日间收治的120例食管癌胸腔镜手术患者,根据患者术前接受的治疗方案分为对照组和研究组,其中64例对照组患者实施新辅助化疗,56例研究组患者实施新辅助化疗联合免疫治疗,两组患者均治疗2个疗程后评估临床疗效,同时对比患者治疗前后肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)和鳞状细胞癌抗原(SCC-Ag),以及T淋巴细胞亚群CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞和CD8^(+)T淋巴细胞的水平差异,对比两组患者治疗期间化疗不良反应的发生率差异。结果研究组患者的客观缓解率(48.21%)以及疾病控制率(92.86%)均明显高于对照组(29.69%,79.69%),差异均有统计学意义(P<0.05)。治疗前,两组患者肿瘤标志物CEA、SCC-Ag和CYFRA21-1的表达水平比较,差异无统计学意义(P>0.05);治疗后两组患者CEA、SCC-Ag和CYFRA21-1表达水平均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者各T淋巴细胞亚群分布水平比较,差异无统计学意义(P>0.05)。治疗后,两组患者CD3^(+)和CD4^(+)水平均低于治疗前,但研究组高于对照组,差异均有统计学意义(P<0.05);治疗后,对照组CD8^(+)水平低于治疗前,研究组CD8^(+)水平高于治疗前,且研究组CD8^(+)T水平高于对照组,差异有统计学意义(P<0.05)。在两组患者治疗期间,两组患者出现最高和最低的不良反应均分别为“血液和淋巴系统异常”和“甲状腺功能异常”,其中研究组患者“血液和淋巴系统异常”的发生率为23.21%,显著低于对照组(45.31%),差异具有统计学意义(P<0.05);其余不良反应发生率对比差异无统计学意义(P>0.05)。结论在接受胸腔镜手术的食管癌患者术前开展新辅助化疗联合免疫疗法临Objective To analyze the impact of neoadjuvant chemotherapy combined with immunotherapy on esophageal cancer patients undergoing thoracoscopic surgery.Methods A total of 120 esophageal cancer patients who underwent thoracoscopic surgery at Xun County People's Hospital from September 13,2022,to May 28,2024,were included based on relevant criteria.According to the treatment regimens received prior to surgery,patients were divided into a control group(64 patients receiving neoadjuvant chemotherapy)and a study group(56 patients receiving neoadjuvant chemotherapy combined with immunotherapy).Both groups were evaluated for clinical efficacy after 2 treatment cycles,and differences were compared in tumor markers including carcinoembryonic antigen(CEA),cytokeratin fragment antigen 21-1(CYFRA21-1),and squamous cell carcinoma antigen(SCC-Ag),as well as T lymphocyte subpopulations(CD3^(+)T cells,CD4^(+)T cells,and CD8^(+)T cells)before and after treatment.The incidence of adverse reactions during chemotherapy was also compared between the two groups.Results The objective response rate(48.21%)and disease control rate(92.86%)in the study group were significantly higher than those in the control group(29.69%and 79.69%,respectively),with statistically significant differences(P<0.05).Before treatment,there were no significant differences in the levels of tumor markers CEA,SCC-Ag,and CYFRA21-1 between the two groups(P>0.05).After treatment,the levels of CEA,SCC-Ag,and CYFRA21-1 in both groups decreased compared to before treatment,with the study group showing lower levels than the control group,and these differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the distribution levels of T lymphocyte subpopulations between the groups(P>0.05).After treatment,the levels of CD3^(+)and CD4^(+)T cells in both groups decreased compared to before treatment,but the study group had higher levels than the control group(P<0.05).Additionally,the CD8^(+)T cell levels decreased in the control

关 键 词：食管癌 新辅助化疗 信迪利单抗 临床疗效 T淋巴细胞 

分 类 号：R735.1[医药卫生—肿瘤]