TP方案联合贝伐单抗治疗晚期非小细胞肺癌的临床疗效及对T淋巴细胞程序性死亡受体1和细胞毒性T淋巴细胞相关抗原4表达的影响

Clinical Efficacy of TP Regimen Combined with Bevacizumab in the Treatment of Advanced Non-small Cell Lung Cancer and its Effect on the Expression of T Lymphocyte Programmed Death Receptor 1 and Cytotoxic T Lymphocyte-associated Antigen 4

目的:探讨TP方案联合贝伐单抗治疗晚期非小细胞肺癌(Non-small cell lung cancer,NSCLC)的临床疗效及对T淋巴细胞程序性死亡受体1(PD-1)、细胞毒性T淋巴细胞相关抗原,(CTLA-4)表达的影响研究。方法:选择2014年6月-2017年9月来样本医院治疗的100例晚期NSCLC癌患者作为研究对象,按照随机数表法分为研究组和对照组,每组各50例。对照组给予TP方案(紫杉醇+顺铂)治疗,研究组在对照组的基础上联合贝伐单抗治疗。分析比较两组患者的临床疗效和不良反应发生率;比较患者血管内皮生长因子(VEGF)和癌胚抗原(CEA)表达;比较T淋巴细胞PD-1、细胞毒性T淋巴细胞CTLA-4表达水平。随访患者3年,比较两组患者的总生存期和无进展生存期。结果:研究组的临床疗效明显优于对照组,客观缓解率明显高于对照组,疾病控制率明显高于对照组,差异有统计学意义(u=0.350,χ^(2)=6.000、4.760,P<0.05);研究组的无进展生存期和总生存期明显优于对照组,差异有统计学意义(P<0.05);治疗后,研究组患者的VEGF、CEA、PD-1和CTLA-4表达水平明显低于对照组,差异有统计学意义(t=5.150、10.010、2.090、2.210,P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(t=0.065,P>0.05)。结论:TP方案联合贝伐单抗治疗晚期NSCLC肺癌安全有效,并增加患者总生存时间和无进展生存期,抑制T淋巴细胞PD-1和CTLA-4表达。

Objective:To investigate the clinical efficacy of TP regimen combined with bevacizumab in the treatment of advanced non-small lung cancer and its effect on the expression of T lymphocyte programmed death receptor 1(PD-1)and cytotoxic T lymphocyte-associated antigen 4(CTLA-4)in T lymphocytes.Methods:A total of 100 patients with advanced non-small cell lung cancer treated in the hospital from June 2014 to September 2017 were selected as the research subjects,and divided into study group and control group according to the random number table method,with 50 cases in each group.The control group was treated with TP regimen(paclitaxel+cisplatin),and the study group was treated with bevacizumab on the basis of the control group.The clinical efficacy and incidence of adverse reactions were compared between the two groups of patients.Vascular endothelial growth factor(VEGF)and carcinoembryonic antigen(CEA)expressions were compared in patients.The expression levels of PD-1 and CTLA-4 were compared.The patients were followed up for 3 years,and the overall survival and progression-free survival were compared between the two groups.Results:The clinical efficacy of the study group was significantly better than that of the control group,and the objective remission rate and disease control rate were significantly higher than those of the control group,and the difference was statistically significant(u=0.350,χ^(2)=6.000,4.760,P<0.05).The progression-free survival and overall survival of the study group were significantly better than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the expression level of VEGF,CEA,PD-1 and CTLA-4 in the study group were significantly lower than those in the control group,and the differences were statistically significant(t=5.150,10.010,2.090,2.210,P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(t=0.065,P>0.05).Conclusion:TP regimen combined with bevacizumab is safe and effective in the treatment of advanced NSCLC,and can increase the overall survival time and progression-free survival of patients,and inhibit the expression of PD-1 and CTLA-4 in T lymphocytes.