特瑞普利单抗注射液联合长春瑞滨+顺铂化疗一线治疗晚期NSCLC的效果及对外周血淋巴细胞PD-1变化的影响

Effect of toripalimab injection combined with NP chemotherapy in first-line treatment of advanced NSCLC and the influence on changes of PD-1 in peripheral blood lymphocytes

目的探究特瑞普利单抗注射液联合长春瑞滨+顺铂(NP)方案化疗一线治疗晚期非小细胞肺癌(NSCLC)的效果及对外周血淋巴细胞程序性死亡受体1(PD-1)变化的影响。方法选取2021年1月至2022年1月我院收治的82例NSCLC患者作为研究对象,随机分为2组,对照组41例,采用NP化疗方案;观察组41例,采用NP+特瑞普利单抗注射液治疗。比较两组疗效,治疗前后肿瘤标志物水平[癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)、糖类抗原199(CA199)],生活质量核心量表(QLQ-C30)评分,免疫功能(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)),外周血PD-1 mRNA、PD-L1 mRNA水平及毒副反应发生率。结果观察组临床获益率、客观缓解率高于对照组(78.05%vs.56.10%,48.78%vs.26.83%,P<0.05)。治疗后,观察组血清CEA、CYFRA21-1、CA125、CA199水平低于对照组(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组(P<0.05),PD-1 mRNA、PD-L1 mRNA水平低于对照组(P<0.05);两组间毒副反应发生率比较差异无统计学意义(P>0.05)。结论特瑞普利单抗注射液联合NP化疗一线治疗晚期NSCLC效果显著,可调节PD-1表达,增强免疫力,改善生活质量,降低肿瘤标志物水平,且安全性高。

Objective To explore the effect of teriprizumab injection combined with NP chemotherapy in first-line treatment of non-small-cell lung cancer(NSCLC)and the effect on the change of peripheral blood lymphocyte programmed death receptor 1(PD-1).Methods A total of 82 NSCLC patients admitted to our hospital from January 2021 to January 2022 were selected as the research subjects and were randomly divided into two groups.Forty-one cases in control group were treated with NP chemotherapy,and 41 cases in observation group were treated with NP and toripalimab injection.The efficacy,the level of tumor markers[carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 125(CA125),CA199],quality of life core scale(QLQ-C30)score,immune function(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)),peripheral blood PD-1 mRNA and PD-L1 mRNA levels before and after treatment and the incidence of side effects were compared between the two groups.Results The clinical benefit rate and the objective response rate of observation group were higher than those of control group(78.05%vs.56.10%,48.78%vs.26.83%,P<0.05).After treatment,the serum levels of CEA,CYFRA21-1,CA125 and CA199 in observation group were lower than those in control group(P<0.05);the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in observation group were higher than those in control group(P<0.05);the levels of PD-1 mRNA and PD-L1 mRNA in observation group were lower than those in control group(P<0.05).There was no significant difference in the incidence of side effects between the two groups(P>0.05).Conclusion Teriprizumab injection combined with NP chemotherapy has a significant effect in first-line treatment of advanced NSCLC.It can effectively regulate PD-1 expression,enhance immune function,improve quality of life,and reduce tumor marker levels with good safety.