程序性死亡受体配体1抑制剂对非小细胞肺癌患者免疫功能指标的影响  

Effect of programmed cell death 1 ligand 1 inhibitor on immune function indexes in patients with non-small cell lung cancer

作　　者：张海鸽 肖燕 刘一博 谢照耀 王浩 ZHANG Haige;XIAO Yan;LIU Yibo;XIE Zhaoyao;WANG Hao(Department of Radiotherapy,the First Affiliated Hospital of He’nan University of Science and Technology,Luoyang 471000,He’nan,China;Oncology Center,Xiamen Humanity Hospital,Xiamen 361016,Fujian,China)

机构地区：[1]河南科技大学第一附属医院放疗科,河南洛阳471000 [2]厦门弘爱医院肿瘤中心,福建厦门361016

出　　处：《癌症进展》2025年第2期163-166,共4页Oncology Progress

基　　金：国家自然科学基金(82002806)。

摘　　要：目的探讨程序性死亡受体配体1(PD-L1)抑制剂对非小细胞肺癌患者免疫功能指标的影响。方法根据治疗方法的不同将60例非小细胞肺癌患者分为对照组29例和观察组31例。对照组患者采取化疗+调强放疗,观察组患者在对照组的基础上联合PD-L1抑制剂治疗。比较两组患者的临床疗效、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、肿瘤标志物[细胞角质蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)及癌胚抗原(CEA)]及不良反应发生情况。结果观察组患者的疾病控制率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者CD4^(+)水平及CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)水平均较治疗前降低,且观察组患者CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者CYFRA21-1、CEA及CA125水平均较治疗前降低,且观察组患者CYFRA21-1、CEA及CA125水平均低于对照组,差异均有统计学意义(P<0.05)。两组患者各不良反应发生率比较,差异均无统计学意义(P>0.05)。结论非小细胞肺癌患者采取化疗+调强放疗联合PD-L1抑制剂治疗效果满意,可增强免疫功能,调节肿瘤标志物水平,且安全性高,有临床应用价值。Objective To investigate the effect of programmed cell death 1 ligand 1(PD-L1)inhibitor on immune function indexes in patients with non-small cell lung cancer.Method According to different treatment methods,60 patients with NSCLC were divided into control group(29 cases)and observation group(31 cases).The control group was treated with chemotherapy+intensity modulated radiotherapy,and the observation group was treated with PD-L1 inhibitor on the basis of the control group.The clinical efficacy,immune function indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),tumor markers[cyto-keratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 125(CA125)and carcinoembryonic antigen(CEA)]and the incidence of adverse reactions were compared between the two groups.Result The disease control rate of observation group was higher than that of control group,the difference was statistically significant(P<0.05).After treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)in two groups were higher than those before treatment,and the levels of CD8^(+)in two groups were lower than those before treatment,and the level of CD4^(+)and CD4^(+)/CD8^(+)in observation group were higher than those in control group,and the level of CD8^(+)in observation group was lower than that in control group,the differences were statistically significant(P<0.05).After treatment,the levels of CYFRA21-1,CEA and CA125 in two groups were lower than those before treatment,and the levels of CYFRA21-1,CEA and CA125 in observation group were lower than those in control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidences of adverse reactions between two groups(P>0.05).Conclusion The effect of chemotherapy plus intensity modulated radiotherapy combined with PD-L1 inhibitor in the treatment of non-small cell lung cancer patients is satisfactory,which can enhance immune function and regulate the level of tumor markers,and has high safety and clinical application value.

关 键 词：非小细胞肺癌 调强放疗 程序性死亡受体配体1抑制剂 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]