重组人血管内皮抑制素联合顺铂化疗方案对中晚期非小细胞肺癌患者外周血sPD-L1、CEA水平的影响

Effects of recombinant human endostatin combined with cisplatin chemotherapy on the levels of sPD-L1 and CEA in patients with advanced non-small cell lung cancer

目的探讨重组人血管内皮抑制素注射液（恩度）联合顺铂化疗方案对中晚期非小细胞肺癌患者外周血可溶性程序性死亡配体-1（sPD-L1）、癌胚抗原（CEA）水平的影响。方法选取2014年2月—2015年2月四川大学华西医院肿瘤科收治的100例中晚期非小细胞肺癌患者为研究对象,按随机数字表法分为对照组和观察组各50例。对照组采用紫杉醇、顺铂静脉注射,观察组在对照组基础上给予恩度注射液。观察对比2组患者临床疗效、sPDL1、CEA水平、生存质量改善情况和不良反应。结果观察组近期总有效率68.0%（34/50）优于对照组18.0%（9/50）,差异具有统计学意义（P〈0.05）;与治疗前比较,2组治疗后sPD-L1、CEA均明显降低（P〈0.05）,且观察组sPD-L1低于对照组[（1.21±0.36）ng/ml vs.（1.50±0.40）ng/ml,t=3.811,P〈0.05],CEA亦低于对照组[（10.24±3.02）ng/ml vs.（15.78±4.21）ng/ml,t=7.561,P〈0.05];观察组生存质量总改善率优于对照组[80.0%（40/50）vs.38.0%（19/50）,χ^2=18.231,P〈0.05];观察组不良反应总发生率低于对照组[10.0%（5/50）vs.34.0%（17/50）,χ^2=8.392,P〈0.05]。结论恩度联合顺铂化疗方案对中晚期非小细胞肺癌患者有显著效果,且不增加化疗的不良反应,安全性好。

Objective To study the influence of recombinant human endostatin injection（Endostar）combined with cisplatin chemotherapy for advanced non small cell lung cancer patients on the levels of programmed death ligand-1（sPD-L1）and carcinoembryonic antigen（CEA） in peripheral blood soluble.Methods One hundred patients with advanced non small cell lung cancer from February 2014 to February 2015 in Department of oncology,West China Hospital,Sichuan University were collected.According to the random number table method,they were divided into the control group and the observation group,50 cases for each group.Paclitaxel and cisplatin were used in the control group,while the observation group was given Endostar injection on the basis of the treatment of control group.Clinical efficacy,sPD-L1,CEA level,quality of life improvement and adverse reactions were observed and compared between the 2 groups.Results Recent total effective rate of the observation group was 68.0%（34/50）,better than that in the control group 18.0%（9/50）,and the difference was statistically significant（P〈0.05）.Compared with those before treatment,the levels of sPD-L1 and CEA were significantly lower in both groups after treatment（P〈0.05）,and sPD-L1 in the observation group was lower than control group[（1.21 ±0.36） ng/ml vs.（1.50±0.40）ng/ml];CEA was lower than control group[（10.24 ±3.02）ng/ml vs.（15.78±4.21）ng/ml].The differences were statistically significant（t=3.811,7.561,P〈0.05）;Total improvement rate of quality of life in the observation group was better than the control group[80.0%（40/50）vs.38.0%（19/50）].The difference was statistically significant（χ^2=18.231,P〈0.05）;Total incidence of adverse events in the observation group was lower than the control group[10.0%（5/50）vs.34.0%（17/50）],the difference was statistically significant（χ^2=8.392,P〈0.05）.Conclusion Endostar combined with cisplatin chemotherapy in the treatment of patients with advanced non small cell lung cancer has a significant effect,which is safety and would not increase adverse reactions of chemotherapy.