局部微波消融联合免疫治疗对肺癌患者血清CYFRA21-1、VEGF及Th1、Th2细胞因子水平的影响  

Effects of local microwave ablation combined with immunotherapy on serum CYFRA21-1,VEGF,Th1,Th2 cytokines levels in patients with lung cancer

作　　者：刘海燕 宋健 陈晓琳 宋苗苗 徐锋 LIU Hai-yan;SONG Jian;CHEN Xiao-lin(Respiratory and Critical Care Medicine,Cangzhou City People's Hospital,Cangzhou Hebei 061000,China;Medical Record Management Room,Cangzhou City People's Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]沧州市人民医院呼吸与危重症医学科,河北沧州061000 [2]沧州市人民医院病案管理室,河北沧州061000

出　　处：《临床和实验医学杂志》2024年第24期2597-2601,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省重点研发项目(编号:18277781D)。

摘　　要：目的观察局部微波消融联合免疫治疗对肺癌患者血清细胞角蛋白19片段(CYFRA21-1)、血管内皮生长因子(VEGF)、辅助性T细胞1(Th1)、辅助性T细胞2(Th2)的影响。方法前瞻性选取2020年1月至2023年1月沧州市人民医院收治的84例NSCLC患者作为研究对象。按照随机数字表法将其分为观察组和对照组,每组各42例。对照组采用吉西他滨联合顺铂治疗(GP方案),观察组采用局部微波消融联合帕博利珠单抗治疗。比较两组的临床疗效,检测并比较两组治疗前和治疗2个周期后,血清CYFRA21-1、VEGF、Th1、Th2水平,比较两组不良反应发生率。随访1年,观察两组生存和复发情况。结果观察组总有效率为80.95%,高于对照组(59.52%),差异有统计学意义(P<0.05)。治疗2个周期后,两组CYFRA21-1、VEGF水平均较治疗前降低,且观察组的CYFRA21-1、VEGF水平分别为(3.62±0.59)μg/L、(251.12±61.63)pg/mL,均低于对照组[(4.47±0.81)μg/L、(386.37±84.59)pg/mL],差异均有统计学意义(P<0.05)。治疗2个周期后,两组Th1、Th2、Th1/Th2水平均较治疗前降低,且观察组Th1、Th2、Th1/Th2水平分别为(1.95±0.41)%、(1.75±0.49)%、1.25±0.28,均低于对照组[(3.81±0.58)%、(2.48±0.63)%、1.49±0.42],差异均有统计学意义(P<0.05)。两组各不良反应发生率比较,差异均无统计学意义(P>0.05)。两组1年复发率比较,差异无统计学意义(P>0.05);观察组1年生存率为88.10%,高于对照组(69.05%),差异有统计学意义(P<0.05)。结论与GP方案化疗相比,局部微波消融联合免疫治疗NSCLC患者有利于提高临床疗效,在抑制血清肿瘤标志物、改善免疫功能方面效果较好,有利于提高患者1年生存率。Objective To observe the effects of local microwave ablation combined with immunotherapy on serum cytokeratin-19 fragment(CYFRA21-1),vascular endothelial growth factor(VEGF),helper T cell 1(Th1)and helper T cell 2(Th2)in patients with lung cancer.Methods A total of 84 patients with NSCLC admitted to Cangzhou People's Hospital from January 2020 to January 2023 were prospectively selected as the study subjects.According to the random number table method,they were divided into the observation group and the control group,with 42 cases in each group.The control group was treated with gemcitabine combined with cisplatin(GP regimen),and the observation group was treated with local microwave ablation combined with pabolizumab.The clinical effect of the two groups was compared.Serum levels of CYFRA21-1,VEGF,Th1 and Th2 were detected.The incidence of adverse reactions was compared between the two groups.Follow-up for 1 year,the survival and recurrence of the two groups were observed.Results The total effective rate of the observation group was 80.95%,which was higher than that of the control group(59.52%),and the difference was statistically significant(P<0.05).After 2 cycles of treatment,the levels of CYFRA21-1 and VEGF in the two groups were lower than those before treatment,and the levels of CYFRA21-1 and VEGF in the observation group were(3.62±0.59)μg/L and(251.12±61.63)pg/mL,respectively,which were lower than those in the control group[(4.47±0.81)μg/L,(386.37±84.59)pg/mL],the differences were statistically significant(P<0.05).After 2 cycles of treatment,the levels of Th1,Th2 and Th1/Th2 in the two groups were lower than those before treatment,and the levels of Th1,Th2 and Th1/Th2 in the observation group were(1.95±0.41)%,(1.75±0.49)%and 1.25±0.28,respectively,which were lower than those in the control group[(3.81±0.58)%,(2.48±0.63)%and 1.49±0.42],the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two gro

关 键 词：肺癌 局部微波消融 免疫检查点抑制剂 肿瘤标志物 免疫功能 

分 类 号：R73[医药卫生—肿瘤]