摘要
目的研究卡瑞利珠单抗联合白蛋白结合型紫杉醇+顺铂化疗用于局部晚期食管癌术前的效果以及对外周血T淋巴细胞程序性死亡受体-1(PD-1)、程序性死亡配体1(PD-L1)水平的影响。方法73例局部晚期食管癌患者,采用电脑系统随机分为对照组(36例)和研究组(37例)。对照组术前采用白蛋白结合型紫杉醇+顺铂化疗治疗,研究组术前在对照组基础上加用卡瑞利珠单抗治疗。比较两组患者PD-1、PD-L1水平,免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)),疗效,不良反应发生情况。结果治疗前,两组患者的PD-1、PD-L1水平比较差异无统计学意义(P>0.05);治疗后,两组患者的PD-1、PD-L1水平均低于本组治疗前,研究组患者的PD-1(244.47±15.72)ng/L、PD-L1(292.13±21.67)ng/L均低于对照组的(258.89±13.64)、(314.98±22.54)ng/L,差异具有统计学意义(P<0.05)。治疗前,两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)比较差异无统计学意义(P>0.05);治疗后,研究组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)分别为(58.75±4.52)%、(39.02±3.34)%、(1.56±0.35),均高于对照组的(55.46±4.63)%、(36.58±3.21)%、(1.13±0.44),差异具有统计学意义(P<0.05)。研究组患者的总有效率为89.19%,显著高于对照组的69.44%,差异具有统计学意义(P<0.05)。两组患者胃肠道反应、腹泻、骨髓抑制、肝功能损伤的发生率比较差异均无统计学意义(P>0.05)。结论局部晚期食管癌患者术前采用卡瑞利珠单抗联合白蛋白结合型紫杉醇+顺铂化疗可有效降低患者的PD-1、PD-L1水平,提升免疫功能指标,有助于控制病灶进展,效果显著,且安全性良好。
Objective To study the effect of camrelizumab combined with albumin-binding paclitaxel+cisplatin chemotherapy on preoperative treatment of locally advanced esophageal cancer and its influence on programmed death-1(PD-1)and programmed death ligand-1(PD-L1)levels.Methods A total of 73 patients with locally advanced esophageal cancer were randomly divided into control group(36 cases)and study group(37 cases).The control group was treated with albumin-binding paclitaxel+cisplatin chemotherapy preoperatively,and the study group was treated with camrelizumab preoperatively on the basis of the control group.The levels of PD-1 and PD-L1,immune function indicators(CD3^(+),CD4^(+) and CD4^(+)/CD8^(+)),efficacy and occurrence of adverse reactions were compared between the two groups.Results Before treatment,there was no statistically significant difference in PD-1 and PD-L1 levels between the two groups(P>0.05).After treatment,the levels of PD-1 and PD-L1 in both groups were lower than those before treatment in this group;PD-1 of(244.47±15.72)ng/L and PD-L1 of(292.13±21.67)ng/L in the study group were lower than those of(258.89±13.64)and(314.98±22.54)ng/L in the control group;the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) between the two groups(P>0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the study group were(58.75±4.52)%,(39.02±3.34)% and(1.56±0.35),which were higher than those of(55.46±4.63)%,(36.58±3.21)% and(1.13±0.44)in the control group,and the differences were statistically significant(P<0.05).The total effective rate of the study group was 89.19%,which was significantly higher than that of 69.44% of the control group,and the difference was statistically significant(P<0.05).The differences in the incidence of gastrointestinal reaction,diarrhea,bone marrow suppression and liver function injury between the two groups were not statistically significant(P>0.05).Conclusion Application of camrelizumab combined with albumin-binding paclitaxel+cisplatin chemotherapy preoperatively has significant efffect for patients with locally advanced esophageal cancer,and can effectively reduce the levels of PD-1 and PD-L1 in patients,enhance the immune function indicators,and help control the progression of the lesion with high safety.
作者
陈仙芳
郭庆森
CHEN Xian-fang;GUO Qing-sen(Department of Oncology,Putian 95th Hospital,Putian 351100,China)
出处
《中国现代药物应用》
2023年第18期1-5,共5页
Chinese Journal of Modern Drug Application
