程序性死亡受体1免疫治疗联合抗血管生成治疗对肺腺癌患者癌性因子水平、生存质量及预后的影响  

Effects of programmed death-1 immunotherapy combined with anti-angiogenesis therapy on levels of cancerous factors,quality of life and prognosis of lung adenocarcinoma patients

作　　者：徐满珍 付陆军[2] 黎瑶 XU Manzhen;FU Lujun;LI Yao(Department of Internal-Oncology,Xinyu People's Hospital,Jiangxi Province,Xinyu 338025,China;Department of Internal-Oncology,Fengcheng People's Hospital,Jiangxi Province,Fengcheng331100,China;Department of Oncology,Xinyu People's Hospital,Jiangxi Province,Xinyu 338025,China)

机构地区：[1]江西省新余市人民医院肿瘤内科,江西新余338025 [2]江西省丰城市人民医院肿瘤内科,江西丰城331100 [3]江西省新余市人民医院肿瘤科,江西新余338025

出　　处：《中国当代医药》2025年第11期60-64,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202410782)。

摘　　要：目的观察程序性死亡受体1(PD-1)免疫治疗联合抗血管生成治疗肺腺癌的近期效果。方法选取2022年1月至2023年5月新余市人民医院收治的64例肺腺癌患者为研究对象,按照随机数字表法分为观察组与对照组,每组各32例。对照组采用PD-1免疫治疗,观察组接受PD-1免疫治疗联合贝伐单抗。比较两组临床有效率、免疫功能、卡氏功能状态评分、癌性因子水平[癌胚抗原(CEA)、细胞角蛋白片段19(CYFRA21-1)、血清神经元特异性烯醇化酶(NSE)]、生存质量、无进展生存期(PFS)及不良反应发生率。结果观察组DCR高于对照组,差异有统计学意义(P<0.05);观察组的CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05);两组患者卡氏功能状态评分变化比较,差异无统计学意义(P>0.05)。观察组的CEA、CYFRA21-1、NSE水平均低于对照组,差异有统计学意义(P<0.05)。观察组治疗后简易生存质量量表评分及PFS高于对照组,差异有统计学意义(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)。结论肺腺癌患者中采用PD-1免疫治疗联合抗血管生成治疗能够增强患者细胞免疫功能,降低癌性因子血清水平,改善患者生活质量,延长患者PFS,且具有一定安全性。Objective To observe the short-term efficacy of programmed death-1(PD-1)immunotherapy combined with anti-angiogenesis therapy in the treatment of lung adenocarcinoma.Methods A total of 64 patients with lung adenocarcinoma admitted to Xinyu People's Hospital from January 2022 to May 2023 were selected as the study objects,and they were divided into observation group and control group by random number table method,with 32 cases in each group.The control group received PD-1 immunotherapy,and the observation group received PD-1 immunotherapy combined with Bevacizumab.The clinical response rate,immune function,Karnofsky performance status,cancer factor level(carcinoembryonic antigen[CEA],cytokeratin 19 fragment antigen 21-1[CYFRA21-1],neuron specific enolase[NSE]),quality of life,progression free survival(PFS)and incidence of adverse reactions were compared between the two groups.Results DCR in observation group was higher than that in control group,the difference was statistically significant(P<0.05).The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and the levels of CD8^(+)were lower than those in the control group,with statistical significances(P<0.05).There was no significant difference in change of Karnofsky performance status between the two groups(P>0.05).The levels of CEA,CYFRA21-1 and NSE in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).The quality of life brief scale score after treatment and PFS of the observation group were higher than those of the 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 In patients with lung adenocarcinoma,PD-1 immunotherapy combined with anti-angiogenesis therapy can enhance the cellular immune function of patients,reduce the serum level of cancer factors,improve the quality of life of patients,prolon

关 键 词：肺腺癌 程序性死亡受体-1免疫 抗血管生成 癌性因子 生存质量 预后 

分 类 号：R734.2[医药卫生—肿瘤]