PD-1抑制剂联合FP化疗方案治疗食管癌患者的临床疗效及对IL-6/STAT3信号通路因子的影响  

Clinical efficacy of PD-1 inhibitor combined with FP chemotherapy in the treatment of patients with esophageal cancer and its effect on IL-6/STAT3 signaling pathway factors

作　　者：刘玲[1] 丁洁[1] 王娟[1] LIU Ling;DING Jie;WANG Juan(Department of Oncology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 210011,China)

机构地区：[1]南京医科大学第二附属医院肿瘤科,江苏南京210011

出　　处：《临床和实验医学杂志》2025年第3期253-257,共5页Journal of Clinical and Experimental Medicine

基　　金：南京市卫生科技发展项目(编号:YKK18190);国家自然科学基金委员会青年科学基金项目(编号:81802373)。

摘　　要：目的探讨程序性死亡受体1(PD-1)抑制剂联合5-氟尿嘧啶+顺铂(FP)方案化疗治疗食管癌患者的临床疗效对白细胞介素-6(IL-6)/信号传导因子及转录激活子3(STAT3)信号通路因子的影响。方法前瞻性选取2020年4月至2023年4月南京医科大学第二附属医院接诊的84例食管癌患者,按照随机数字表法将其分为两组:对照组与联合组,每组各42例。对照组采取FP化疗方案治疗,联合组采取联合PD-1抑制剂治疗。21 d为1个周期,两组均持续治疗4个周期。观察两组的临床疗效、不良反应,比较两组治疗前、治疗3个月后的IL-6/STAT3信号通路因子指标[IL-6、STAT3、细胞周期蛋白(Cyclin)D1、基质金属蛋白酶-2(MMP-2)]、生活质量[生活质量核心问卷(EORTC QLQ-C30)]评分和生存情况。结果联合组的临床总控制率为66.67%,高于对照组(45.24%),差异有统计学意义(P<0.05)。联合组与对照组的总不良反应发生率比较,差异无统计学意义(P>0.05)。治疗3个月后,两组的STAT3、IL-6、Cyclin D1、MMP-2水平均较治疗前降低,联合组的STAT3、IL-6、Cyclin D1、MMP-2水平分别为(1.76±0.13)ng/L、(34.28±6.49)ng/L、(41.64±6.83)U/L、(69.85±9.97)ng/mL,均低于对照组[(2.06±0.19)ng/L、(49.52±8.61)ng/L、(48.61±8.11)U/L、(88.47±8.53)ng/mL],差异均有统计学意义(P<0.05)。治疗3个月后,两组EORTC QLQ-C30评分均较治疗前升高,联合组的躯体功能、情绪功能、社会功能评分分别为(70.85±12.37)、(73.88±12.49)、(74.75±12.43)分,均高于对照组[(60.74±6.72)、(60.55±8.76)、(59.84±13.84)分],差异均有统计学意义(P<0.05)。随访12个月,两组累积生存率比较,差异无统计学意义(P>0.05)。结论PD-1抑制剂联合FP化疗方案对食管癌患者有一定的疗效,能提高患者生活质量,且不会额外增加不良反应,其机制可能是与抑制IL-6/STAT3信号通路相关。Objective To investigate the clinical efficacy of programmed cell death 1(PD-1)inhibitor combined with 5-fluorouracil+cisplatin(FP)chemotherapy regimen in the treatment of patients with esophageal cancer and its effect on interleukin-6(IL-6)/signal transducer and activator of transcription3(STAT3)signaling pathway factors.Methods A total of 84 patients with esophageal cancer admitted to the Second Affiliated Hospital of Nanjing Medical University from April 2020 to April 2023 were prospectively selected and divided into two groups according to the random number table method:the control group and the combination group,with 42 cases in each group.The control group was treated with FP chemotherapy regimen,and the combination group was combined with PD-1 inhibitor.21 d as a cycle,and both groups were treated for 4 cycles.The clinical efficacy and adverse reactions of the two groups were observed.The IL-6/STAT3 signaling pathway factors[IL-6,STAT3,Cyclin D1,matrix metalloproteinase-2(MMP-2)],quality of life[European organization for research on treatment of cancer quality of life questionnaire core 30(EORTC QLQ-C30)]scores before treatment and after 3 months of treatment,survival status of the two groups were compared.Results The total clinical control rate of the combination group was 66.67%,which was higher than that of the control group(45.24%),and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of total adverse reactions between the combination group and the control group(P>0.05).After 3 months of treatment,the levels of STAT3,IL-6,Cyclin D1 and MMP-2 in the two groups were lower than those before treatment.The levels of STAT3,IL-6,Cyclin D1 and MMP-2 in the combination group were(1.76±0.13)ng/L,(34.28±6.49)ng/L,(41.64±6.83)U/L and(69.85±9.97)ng/mL,respectively.They were lower than those in the control group[(2.06±0.19)ng/L,(49.52±8.61)ng/L,(48.61±8.11)U/L,(88.47±8.53)ng/mL],the differences were statistically significant(P<0.05).After

关 键 词：食管癌 程序性细胞死亡1抑制剂 化疗 白细胞介素-6/信号传导因子及转录激活子3信号通路 

分 类 号：R735.1[医药卫生—肿瘤]