纳武利尤单抗联合伊立替康治疗老年胃癌患者的疗效  

Efficacy of nivolumab combined with irinotecan in the treatment of elderly patients with gastric cancer

作　　者：徐卓元 王若雨[2] XU Zhuoyuan;WANG Ruoyu(Department of Clinical Medicine,Dalian University,Dalian 116622,Liaoning,China;Department of Oncology,Affiliated Zhongshan Hospital of Dalian University,Dalian 116101,Liaoning,China)

机构地区：[1]大连大学临床医学系,辽宁大连116622 [2]大连大学附属中山医院肿瘤科,辽宁大连116101

出　　处：《癌症进展》2025年第7期762-766,共5页Oncology Progress

摘　　要：目的探讨纳武利尤单抗联合伊立替康治疗老年胃癌患者的疗效。方法选取92例老年胃癌患者作为研究对象,采用随机数字表法分为对照组和观察组,每组43例。比较两组患者的临床疗效、肿瘤标志物[糖类抗原(CA)72-4、CA19-9、癌胚抗原(CEA)、CA125、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、基质金属蛋白酶9(MMP9)]水平、免疫功能[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、免疫球蛋白(Ig)A、IgM]、不良反应发生情况及远期预后[无进展生存期(PFS)、总生存期(OS)、1年复发率]。结果观察组患者的疾病控制率高于对照组,PFS、OS均长于对照组,1年复发率低于对照组,差异有统计学意义(P﹤0.05)。治疗后,两组患者CA19-9、CA72-4、CEA、CA125、CYFRA21-1、MMP9、IgA、IgM水平均低于本组治疗前,CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于本组治疗前,观察组患者CA19-9、CA72-4、CEA、CA125、CYFRA21-1、MMP9、IgA、IgM水平均低于对照组,CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(P﹤0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P﹥0.05)。结论纳武利尤单抗联合伊立替康应用于老年胃癌患者中疗效显著,能够有效控制病情进展,降低肿瘤标志物水平,改善免疫功能,降低不良反应发生率,有利于患者预后。Objective To investigate the efficacy of nivolumab combined with irinotecan in the treatment of elderly patients with gastric cancer.Method A total of 92 elderly patients with gastric cancer were selected and divided into control group and observation group by random number table method,with 43 cases in each group.The clinical efficacy,tumor markers[carbohydrate antigen(CA)72-4,CA19-9,carcinoembryonic antigen(CEA),CA125,cyto-keratin 19 fragment antigen 21-1(CYFRA21-1),matrix metalloproteinase 9(MMP9)]level,immune function[CD3^(+),CD4^(+),CD4^(+)/CD8^(+),immunoglobulin(Ig)A,IgM],occurrence of adverse reactions and long-term prognosis[progression-free survival(PFS),overall survival(OS),1-year recurrence rate]of the two groups were compared.Result The disease control rate of observation group was higher than that of control group,PFS and OS were longer than those of control group,and the 1-year recurrence rate was lower than that of control group,the differences were statistically significant(P<0.05).After treatment,the levels of CA19-9,CA72-4,CEA,CA125,CYFRA21-1,MMP9,IgA and IgM in two groups were lower than those before treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were higher than those before treatment,the levels of CA19-9,CA72-4,CEA,CA125,CYFRA21-1,MMP9,IgA and IgM in observation group were lower than those in control group,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were higher than those in control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Nivolumab combined with irinotecan is effective in elderly patients with gastric cancer,which can effectively control the progression of the disease,reduce the levels of tumor markers,improve immune function,reduce the incidence of adverse reactions,and is conducive to the prognosis of patients.

关 键 词：纳武利尤单抗 伊立替康 胃癌 肿瘤标志物 免疫功能 不良反应 

分 类 号：R735.2[医药卫生—肿瘤]