PD-1单抗治疗非小细胞肺癌的疗效及对免疫功能的分析

The Efficacy of PD-1 Monoclonal Antibody in the Treatment of Non-small Cell Lung Cancer and the Analysis of Immune Function

目的探讨PD-1单抗治疗非小细胞肺癌的疗效,以及对患者免疫功能的影响分析。方法选择该院2016年1月—2020年12月化疗或者靶向药物治疗失败后的非小细胞肺癌患者80例,均给予PD-1卡瑞利珠单抗进行治疗,对比治疗前后患者T淋巴细胞亚群、炎症因子水平的变化情况,并观察记录其临床治疗效果。结果经过PD-1单抗治疗后,患者T淋巴细胞亚群指标中CD3+、CD4+、CD4+/CD8+水平分别为(69.73±6.35)%、(40.47±5.41)%、(1.91±0.41),分别高于治疗前的(63.57±5.79)%、(36.05±4.26)%、(1.36±0.26),而CD8+水平为(22.56±2.73)%,低于治疗前的(26.07±3.33)%,治疗前后对比,差异有统计学意义(t=6.412、5.741、10.133、7.291,P<0.05);同时IgA、IgM与IgG水平分别为(4.93±0.85)、(1.47±0.26)、(16.87±3.44)g/L,分别高于治疗前的(3.47±0.59)、(1.21±0.19)、(11.25±2.31)g/L,治疗前后对比,差异有统计学意义(t=12.621、7.222、12.131,P<0.05);且治疗后患者血清炎症因子TNF-α和IL-6水平分别为(91.62±6.90)pg/mL、(52.89±3.81)ng/L,分别低于治疗之前的(393.13±28.84)pg/mL、(80.67±6.23)ng/L,治疗前后对比,差异有统计学意义(t=90.942、34.025,P<0.05)。经过治疗后,患者病情缓解率为61.25%(49/80),临床获益率为88.75%(71/80);且只有13例出现轻微的免疫性肺炎、免疫性心肌炎、甲状腺功能异常及毛细血管增生症等症状,且患者均可耐受,对后续的治疗未产生影响。结论PD-1单抗治疗非小细胞肺癌的疗效显著,可有效的改善患者机体免疫能力,亦可降低其机体炎性反应。

Objective To investigate the efficacy of PD-1 mmab in non-small cell lung cancer and the immune function.Methods From January 2016 to December 2020 in the hospital,80 patients with non-small cell lung cancer who failed chemotherapy or targeted drug therapy were treated with PD-1 carrelizumab.Compare the changes of T lymphocyte subsets and inflammatory factor levels of patients before and after treatment,and observe and record their clinical treatment effects.Results After PD-1 mab treatment,the levels of CD3+,CD4+,CD4+/CD8+in T lymphocyte subsets were(69.73±6.35)%,(40.47±5.41)%,(1.91±0.41),respectively,which were higher than those before treatment(63.57±5.79)%,(36.05±4.26)%,(1.36±0.26),.the levels of CD8+were(22.56±2.73)%,lower than(26.07±3.33)%before and after treatment,and the differences were statistically significant(t=6.412,5.741,10.133,7.291,P<0.05);at the same time,IgA,IgM and IgG levels were(4.93±0.85)g/L,(1.47±0.26)g/L,(16.87±3.44)g/L,respectively,which were higher than(3.47±0.59)g/L,(1.21±0.19)g/L,(11.25±2.31)g/L before treatment,respectively,there were statistically significant differences before and after treatment(t=12.621,7.222,12.131,P<0.05).The levels of TNF-αand IL-6 after treatment were(91.62±6.90)pg/mL and(52.89±3.81)ng/L,respectively,lower than(393.13±28.84)pg/mL and(80.67±6.23)ng/L before treatment,respectively,there were statistically significant differences before and after treatment(t=90.942,34.025,P<0.05).After treatment,the remission rate was 61.25%(49/80),the clinical benefit rate was 88.75%(71/80).Only 13 patients had mild immune pneumonia,immune myocarditis,thyroid dysfunction,and capillary hyperplasia and other symptoms,which were tolerated by the patients and did not affect the subsequent treatment.Conclusion PD-1 mmab in non-small cell lung cancer can effectively improve its immune capacity and reduce its inflammatory response,which is worth promoting.