抗PD-1免疫治疗联合放疗在鼻咽癌患者中的应用效果及对肿瘤标志物的影响

Application Effect of Anti-PD-1 Immunotherapy Combined with Radiotherapy in Patients with Nasopharyngeal Carcinoma and Its Effect on Tumor Markers

目的:探讨抗PD-1免疫治疗联合放疗在鼻咽癌患者中的应用效果及对肿瘤标志物的影响。方法:选取2018年1月-2022年1月赣州市肿瘤医院内科三区收治的鼻咽癌患者113例为研究对象,依据治疗方式的不同分为观察组(n=57)和对照组(n=56),所有患者均给予单抗PD-1治疗,观察组在此基础上均给予放疗。比较两组客观缓解率、肿瘤标志物、生活质量,以及外周血T细胞表面程序性死亡受体(PD-1)、CD8^(+)、自然杀伤细胞(NK细胞)表达水平。结果:治疗1个月后,观察组客观缓解率(ORR)为80.70%,明显高于对照组的64.29%(P<0.05);治疗后两组SCC、CEA水平均降低,且观察组均低于对照组(P<0.05);治疗后,两组PD-1、CD8^(+)细胞表达水平均明显升高(P<0.05),观察组PD-1、CD8^(+)均高于对照组(P<0.05);治疗后,两组鼻腔鼻窦结局测试-20(SNOT-20)评分均降低,观察组低于对照组(P<0.05),两组癌症患者生命质量测定量表(QLQ-C30)评分均升高,且观察组高于对照组(P<0.05)。结论:抗PD-1治疗联合放疗在鼻咽癌患者中临床效果显著,降低血清肿瘤标志物表达水平,提升机体对抗肿瘤功能,改善治疗后的生活质量。

Objective:To investigate the effect of anti-PD-1 immunotherapy combined with radiotherapy in patients with nasopharyngeal carcinoma and its impact on tumor markers.Method:A total of 113 patients with nasopharyngeal carcinoma who were admitted to the Third District of Internal Medicine of Ganzhou Cancer Hospital from January 2018 to January 2022 were selected as the study objects.According to the different treatment methods,they were divided into observation group(n=57)and control group(n=56).All patients were treated with Monoclonal Antibody PD-1,and the observation group was given radiotherapy on this basis.The objective response rate,tumor markers,quality of life,the expression levels of programmed death receptor(PD-1)on the surface of peripheral blood T cells,CD8^(+),natural killer cells(NK cells)were compared between the two groups.Result:One month after treatment,the objective remission rate(ORR)in the observation group was 80.70%,which was significantly higher than 64.29%in the control group(P<0.05).After treatment,the levels of SCC and CEA in both groups decreased,and those in the observation group were lower than those in the control group(P<0.05).After treatment,the expression levels of PD-1 and CD8^(+)cells in both groups increased significantly(P<0.05),and the PD-1 and CD8^(+)cells in the observation group were higher than those in the control group(P<0.05).After treatment,nasal cavity and sinus outcome test-20(SNOT-20)scores decreased in both groups,that in the observation group was lower than that in the control group(P<0.05),and cancer patient quality of life scale(QLQ-C30)scores increased in both groups,and that in the observation group was higher than that in the control group(P<0.05).Conclusion:Anti-PD-1 therapy combined with radiotherapy has a significant clinical effect in patients with nasopharyngeal carcinoma,reducing the expression levels of serum tumor markers,improving the anti-tumor function of the body,and improving the quality of life after treatment.