PD-1/PD-L1免疫治疗联合AP方案对晚期肺腺癌患者炎性细胞因子及免疫功能的影响  

Effect of PD-1/PD-L1 immunotherapy combined with AP regimen on inflammatory cytokines and immune function in patients with advanced lung adenocarcinomas

作　　者：史英[1] 苗恩萍 王倩 SHI Ying;MIAO Enping;WANG Qian(Department of Oncology,Cangzhou Central Hospital,Hebei,Cangzhou 061000,China)

机构地区：[1]河北省沧州市中心医院肿瘤内科,061000

出　　处：《河北医药》2025年第3期428-431,共4页Hebei Medical Journal

基　　金：沧州市重点研发计划指导项目(编号:222106042)。

摘　　要：目的探讨信迪利单抗(PD-1/PD-L1)免疫治疗联合培美曲塞+顺铂(AP)方案对晚期肺腺癌患者炎性细胞因子及免疫功能的影响。方法回顾性分析2019年2月至2022年2月收治的80例晚期肺腺癌患者临床资料,根据患者化疗方案的不同分为对照组(AP方案治疗)和观察组(AP方案+PD-1/PD-L1治疗),每组40例。3周为1个疗程,共治疗6个疗程。比较2组疗效,治疗前和治疗6个疗程时肿瘤标志物水平[糖类抗125(CA125)、癌胚抗原(CEA)]、免疫功能指标、炎性因子水平[C反应蛋白(CRP)肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)],对比2组治疗期间不良反应发生情况,并统计随访1年患者生存情况。结果治疗6个疗程时,对照组缓解率低于观察组(P<0.05);治疗6个疗程时,对照组CA125、CEA水平高于观察组(P<0.05);治疗6个疗程时,对照组CD_(4)^(+)、CD_(3)^(+)水平低于观察组(P<0.05);治疗6个疗程时,对照组血清TNF-α、CRP、IL-6水平高于观察组(P<0.05);治疗期间,2组不良反应发生率比较,差异无统计学意义(P>0.05);随访期间,经Log Rank检验,观察组总生存率高于对照组,差异有统计学意义(χ^(2)=9.608,P=0.002);观察组无进展生存时间长于对照组,差异有统计学意义(t=3.141,P=0.002)。结论晚期肺腺癌患者采用PD-1/PD-L1免疫治疗联合AP方案治疗的疗效显著,可降低患者肿瘤标志物水平和炎性因子水平,改善免疫功能,提高患者生存率,且不会增加不良反应。Objective To investigate the effects of Sintilimab(PD-1/PD-L1)immunotherapy combined with pemetrexed+cisplatin(AP)regimen on inflammatory cytokines and immune function in patients with advanced lung adenocarcinomas.Methods A retrospective analysis was conducted on 80 patients with advanced lung adenocarcinomas admitted to our hospital from February 2019 to February 2022.Clinical data of the patients were collected.They were divided into the control group(AP regimen treatment,40 cases)and observation group(AP regimen+PD-1/PD-L1 treatment,40 cases)based on different chemotherapy regimens.A total of 6 courses,with 3 weeks per cycle were given.The efficacy of the two groups was compared.The levels of tumor markers(carbohydrate anti-125[CA125],carcinoembryonic antigen[CEA]),immune function indexes and inflammatory factors(C-reactive protein[CRP],tumor necrosis factor-α[TNF-α],interleukin-6[IL-6])were compared before and after 6 courses of treatment.The incidence of adverse events during treatment was compared between the two groups,and the survival of patients was followed up for 1 year.Results After 6 courses of treatment,the remission rate in the control group was significantly lower than that in the observation group(P<0.05).After 6 courses of treatment,the levels of CA125 and CEA in the control group were significantly higher than those in the observation group(P<0.05).After 6 courses of treatment,the levels of CD_(4)^(+) and CD_(3)^(+) in the control group were significantly lower than those in the observation group(P<0.05).After 6 courses of treatment,serum TNF-α,CRP and IL-6 in the control group were significantly higher than those in the observation group(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse events between the two groups(P>0.05).During the follow-up period,according to the Log Rank test,the overall survival rate determined by the log-rank test was significantly higher in the observation group than that of the control group(χ^(2)=9.608,P=0.002).

关 键 词：免疫治疗 晚期肺腺癌 炎性细胞因子 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]