培美曲塞联合顺铂对晚期非小细胞肺癌患者免疫功能的影响及效果评估

The Effect of Pemetrexed Combined with Cisplatinfor Treatment of Patients with Non-small Cell Lung Canceronimmunologic Function

目的探讨培美曲塞联合顺铂治疗晚期非小细胞肺癌的临床疗效及其对患者免疫功能的影响。方法选取2014年1月至2016年10月在我院接受化疗的非小细胞肺癌患者100例,随机分为GP组和PP组,每组50例。GP组患者接受吉西他滨联合顺铂化疗,PP组患者接受培美曲赛联合顺铂化疗。分析比较两组患者的临床疗效及化疗前后免疫功能、外周血中血管内皮生长因子(VEGF)及内皮抑素含量的变化。结果 GP组和PP组总缓解率分别为70%和72%,差异无统计学意义(P>0.05);PP组血液学毒性反应的发生率明显低于GP组(P<0.05);两组患者外周血中VEGF含量较化疗前明显降低(P<0.05),且PP组显著低于GP组(P<0.05);两组患者外周血中内皮抑素含量较化疗前明显升高(P<0.05),且PP组明显高于GP组(P<0.05);两组患者CD3+、CD4+细胞数量、CD4+/CD8+比值以及NK细胞活性较化疗前明显升高(P<0.05),且PP组显著高于GP组(P<0.05);两组患者KPS评分较化疗前有所升高,且PP组在治疗不同疗程时的KPS评分均明显高于GP组(P<0.05)。结论培美曲赛联合顺铂治疗非小细胞肺癌可显著降低血液学毒性反应的发生率及外周血中VEGF的含量、促进内皮抑素的分泌,有利于患者免疫功能的恢复。

Objective To explore the effect of pemetrexed combined with cisplatin for treatment of Patients with non-small cell lungcancer on immunologic function.Methods100patients with non-small cell lung cancer were enrolled in our hospital from January2014to October2016,and patients were divided into two groups randomly,the patients in GP group(n=50)were given gemcitabine combinedwith cisplatin,and patients in PP group(n=50)were given pemetrexed combined with cisplatin.After chemotherapy,the curative,immunity,VEGF and endothelin of patients were analyzed between GP groupand PPgroup.Results The total remission rate of GP groupand PPgroupwere70%and72%respectively,and the difference has no significance(P>0.05).The incidence of hematologic toxicity in PP groupwaslower than that in GP group(P<0.05);The VEGF level in the serum of all patients decreased significantly compared with that beforechemotherapy in the two groups(P<0.05),and the amplitude of PP the group was higher than that in GP groupsignificantly(P<0.05).Andthe serum level of endothelin were increased remarkably compared with that before treatment(P<0.05),and the level of that in PP groupwere higher than those GP groupsignificantly(P<0.05);After chemotherapy,the CD3+,CD4+content,CD4+/CD8+and NK cell activityin-creased significantly(P<0.05),and the amplitude of PP group was higher than that in GP group obviously(P<0.05);The KPS level of allpatients increased to some degree,but the score of PP group in different post-treatment period were higher significantly than those GP group.Conclusions Pemetrexed combined with cisplatin for treatment of patients with non-small cell lung cancer could decrease the incidence ofhematologic toxicity obviously and secretion of tumor,promote VEGF and endothelinfactors,and improve the recovery of immunologic function.