GS方案、PD1免疫疗法联合益生菌治疗胰腺癌根治术后患者的临床疗效  

Clinical Efficacy of GS Regimen and PD1 Immunotherapy Combined with Probiotics in Patients after Pancreatic Cancer Resection

作　　者：黄安文 姚礼 吴金秀 汪加宽 焦成文 杨云飞 肖怀文 HUANG Anwen;YAO Li;WU Jinxiu(Pudong New District,Punan Hospital,Shanghai 200125)

机构地区：[1]浦东新区浦南医院,上海200125

出　　处：《医学临床研究》2025年第3期373-375,379,共4页Journal of Clinical Research

基　　金：浦东新区科委民生专项(PKJ1023-Y87);浦东新区卫生健康委员会计划项目(PWRd2020-16)。

摘　　要：【目的】探讨GS方案(吉西他滨联合替吉奥)与PD1免疫疗法联合益生菌治疗胰腺癌根治术后患者的临床疗效。【方法】80例行胰腺癌根治术后的患者,随机分为A组和B组,每组40例。B组接受GS方案联合PD1免疫治疗,A组患者在B组基础上联合益生菌治疗。比较两组患者的临床疗效,治疗前后的炎症指标[中性粒细胞与淋巴细胞比率(NLR)、全身免疫炎症指数(SII)、血小板/淋巴细胞比值(PLR)]、NK细胞和T细胞亚群(CD3^(+)、CD4^(+))、肿瘤标志物[糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、糖类抗原125(CA125)]水平及不良反应发生情况。【结果】A组总有效率为72.50%,高于B组的50.00%(P<0.05);治疗后,两组患者NLR、SII、PLR较治疗前均降低(P<0.05),且A组各项指标均低于B组(P<0.05)。两组患者CA199、CEA、CA125水平较治疗前均降低(P<0.05),且A组各项指标均低于B组(P<0.05)。两组患者NK细胞、CD3^(+)、CD4^(+)较治疗前均升高(P<0.05),且A组各项指标均高于B组(P<0.05)。A组不良反应总发生率为30.00%,低于B组的55.00%(P<0.05)。【结论】GS方案与PD1免疫疗法联合益生菌治疗可提高胰腺癌根治术后患者的免疫功能,降低肿瘤标志物水平和不良反应发生率。【Objective】To explore the clinical efficacy of the GS regimen(gemcitabine combined with tegafur)and PD1 immunotherapy combined with probiotics in patients after pancreatic cancer resection.【Methods】Eighty patients who underwent pancreatic cancer resection were randomly divided into two groups,A and B,with 40 cases in each group.Group B received the GS regimen combined with PD1 immunotherapy,while Group A received the same treatment as Group B,but with the addition of probiotics.The clinical efficacy,pre-treatment and post-treatment inflammatory indicators[neutrophil-to-lymphocyte ratio(NLR),systemic immune-inflammation index(SII),platelet-to-lymphocyte ratio(PLR)],NK cells and T cell subgroups(CD3^(+),CD4^(+)),tumor markers[carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)],and adverse reactions were compared between the two groups.【Results】The total effective rate of Group A was 72.50%,which was higher than Group B's 50.00%(P<0.05).After treatment,NLR,SII,and PLR decreased in both groups(P<0.05),with Group A having significantly lower values than Group B(P<0.05).Tumor markers(CA19-9,CEA,CA125)also decreased in both groups after treatment(P<0.05),with Group A showing lower levels than Group B(P<0.05).NK cells,CD3^(+),and CD4^(+)levels increased in both groups(P<0.05),with Group A showing higher values than Group B(P<0.05).The total incidence of adverse reactions in Group A was 30.00%,which was lower than Group B's 55.00%(P<0.05).【Conclusion】The GS regimen combined with PD1 immunotherapy and probiotics can improve immune function,lower tumor marker levels,and reduce the incidence of adverse reactions in patients after pancreatic cancer resection.

关 键 词：胰腺肿瘤 免疫疗法 鼠李糖乳杆菌 治疗结果 

分 类 号：R735.9[医药卫生—肿瘤]