卡瑞利珠单抗对晚期非小细胞肺癌患者T淋巴细胞亚群的影响分析

Analysis of effect of carrelizumab on T lymphocyte subsets in patients with advanced non-small cell lung cancer

目的:探讨卡瑞利珠单抗对晚期非小细胞肺癌患者T淋巴细胞亚群的影响。方法:选择医院2018年5月至2020年5月接诊的晚期非小细胞肺癌患者63例的病历资料进行回顾性分析。依据患者的用药方法分为对照组和观察组,对照组18例,观察组45例。对照组患者给予培美曲塞,观察组患者在对照组用药基础上给予卡瑞利珠单抗。对比2组患者治疗前及治疗4个周期后的T淋巴细胞亚群变化情况(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+)。分析T淋巴细胞亚群变化情况对患者的近期治疗效果。对比2组患者在治疗期间的不良反应情况。分析全部患者的生存情况及生存时间的影响因素。结果:经过4个周期的治疗,2组患者的CD3~+、CD4~+、CD4~+/CD8~+均增高,CD8~+均降低(P<0.05)。观察组患者的CD3~+、CD4~+、CD8~+、CD4~+/CD8~+数值变化均大于对照组(P<0.05)。利用△CD3~+、△CD4~+、△CD8~+、△CD4~+/CD8~+数值变化率对患者的近期治疗效果进行预测,最佳截断值分别为8.70%、22.80%、18.28%、27.36%,约登指数分别为62.22%、71.11%、56.67%、72.22%。2组患者在治疗期间的各项不良反应对比,数据差异无统计学意义(P>0.05)。在随访的3年内,62例患者死亡,病死率为98.41%。全部患者的生存时间中位数为21.59个月。将患者的生存时间作为因变量,采用Cox比例风险模型进行多因素影响因素分析,结果显示:患者T淋巴细胞群变化情况、化疗次数、卡瑞利珠单抗使用次数,均为患者生存时间的影响因素(P<0.05)。结论:卡瑞利珠单抗能够调节接受化疗的非小细胞肺癌患者的T淋巴细胞亚群变化,有助于改善人体的免疫状态,对延长患者的生存时间具有积极意义。

Objective:To explore the effect of carrelizumab on T lymphocyte subsets in patients with advanced non-small cell lung cancer.Methods:A retrospective analysis of the medical records of 63 patients with advanced non-small cell lung cancer who were admitted to selected hospitals from May 2018 to May 2020.The patients were divided into control group and observation group according to the difference of medication method.There were 18 cases in control group and 45 cases in observation group.Patients in control group were given pemetrexed,and patients in observation group were given carrelizumab on the basis of control group.Com⁃pared the changes of T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)of the two groups before treatment and after 4 cycles of treatment.Analyzed the effect of changes in T lymphocyte subsets on patients'short-term treatment effects.The adverse reactions of the two groups of patients during the treatment period were compared.Analyzed the survival of all patients and the influencing factors of survival time.Results:After 4 cycles of treatment,the CD3+,CD4+,CD4+/CD8+of the two groups increased,and the CD8+decreased(P<0.05).The rate of change in the values of CD3+,CD4+,CD8+,CD4+/CD8+in observation group was greater than that in control group(P<0.05).Using the numerical change rate of△CD3+,△CD4+,△CD8+,△CD4+/CD8+to predict the patient's short-term treat⁃ment effect,the best cut-off values were 8.70%,22.80%,18.28%,27.36%,and the Youden index were 62.22%,71.11%,56.67%,72.22%,respectively.There was no statistically significant difference in the data of adverse reactions between the two groups of patients during the treatment period(P>0.05).Within 3 years of follow-up,62 patients died,with a mortality rate of 98.41%.The median survival time of all patients was 21.59 months.The patient's survival time was used as the dependent variable,and the Cox pro⁃portional hazard model was used to analyze the multi-factor influencing factors.The results showed that the changes in the patient's T lymphocyte population,the number of chemotherapy times,and the number of times of carrelizumab used were all influencing factors of survival time(P<0.05).Conclusion:Carrelizumab can adjust the changes of T lymphocyte subsets in patients with non-small cell lung cancer receiving chemotherapy,help improve the immune status of the human body,and have a certain positive significance for prolonging the survival time of patients.