卡瑞利珠单抗联合阿帕替尼治疗中晚期非小细胞肺癌的疗效

Clinical efficacy of camrelizumab combined with apatinib in the treatment of advanced non-small cell lung cancer

目的探讨卡瑞利珠单抗联合阿帕替尼对中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、角质蛋白21-1(cytokeratins 21-1,CYERA21-1)的影响,并分析其检测价值。方法选取NSCLC患者60例,记录患者的年龄、性别、吸烟史和体质量指数(body mass index,BMI)等一般临床资料。采用静脉滴注卡瑞利珠单抗联合口服甲磺酸阿帕替尼片的治疗方式,共治疗9周。采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测血清MMP-9水平,化学发光法检测血清CYERA21-1水平;受试者工作特征(receiver operating characteristic,ROC)曲线分析血清MMP-9及CYERA21-1对联合治疗疗效的诊断价值;Kaplan-Meier(K-M)分析绘制生存曲线,Log Rankχ^(2)检验比较生存率。结果治疗后,缓解组患者血清MMP-9和血清CYERA21-1水平均明显低于未缓解组(P<0.05);肿瘤直径大、病理分级高和肿瘤转移的NSCLC患者血清MMP-9及CYERA21-1表达水平明显高于肿瘤直径小、病理分级低和肿瘤未转移的患者(P<0.05);血清MMP-9、CYERA21-1及联合鉴别诊断联合治疗疗效的AUC分别为0.769、0.804、0.916;MMP-9、CYERA21-1低水平患者1、2年生存率和1、2年无病生存率均明显高于MMP-9、CYERA21-1高水平患者,MMP-9、CYERA21-1低水平患者中位生存时间明显长于MMP-9、CYERA21-1高水平患者(P<0.05)。结论血清MMP-9及CYERA21-1水平对卡瑞利珠单抗联合阿帕替尼治疗中晚期NSCLC的临床疗效具有较高的检测价值,其水平高低可客观反映患者的治疗缓解情况。

Objective To explore the effects of camrelizumab combined with apatinib on matrix metalloproteinase-9(MMP-9)and cytokeratins 21-1(CYERA21-1)in advanced non-small cell lung cancer(NSCLC),and analyze their detection value.Methods A retrospective analysis was performed on 60 patients confirmed with NSCLC.The general clinical data[age,gender,smoking history,body mass index(BMI)]were recorded.The patients were treated with intravenous injection of camrelizumaband oral Apatinib Mesylate Tablets for 9 weeks.The level of serum MMP-9 was detected by enzyme-linked immuno sorbent assay(ELISA).The level of serum CYERA21-1 was detected by chemiluminescence method.The detection value of MMP-9 and CYERA21-1 for curative effect of combined therapy was analyzed by receiver operating characteristic curves(ROC).The survival curves were drawn by Kaplan-Meier analysis(K-M),and the survival rate was compared by Log Rankχ^(2) test.Results After treatment,the levels of serum MMP-9 and CYERA21-1 in remission group were significantly lower than those in non-remission group(P<0.05).The levels of serum MMP-9 and CYERA21-1 in NSCLC patients with long tumor diameter,high pathological grading and tumor metastasis were significantly higher than those with short tumor diameter,low pathological grading and non-metastasis(P<0.05).AUC values of serum MMP-9,CYERA21-1 and their combination in detection curative effect of combined therapy were 0.769,0.804 and 0.916,respectively.The 1,2-year survival rate and 1,2-year disease-free survival rate in patients with low levels of MMP-9 and CYERA21-1 were significantly higher than those with high levels,and the median survival time was significantly longer than that with high levels(P<0.05).Conclusion The levels of serum MMP-9 and CYERA21-1 are of high detection value for clinical curative effect of camrelizumab combined with apatinib on advanced NSCLC.And their levels can objectively reflect treatment remission in patients.