卡瑞利珠单抗辅助化疗对中晚期NSCLC患者的近期疗效及对细胞免疫、血清肿瘤标志物的影响

Short-term efficacy of camrelizumab in adjuvant chemotherapy for patients with advanced NSCLC and the influence on cellular immunity, serum tumor markers

目的:观察卡瑞利珠单抗辅助化疗对中晚期非小细胞肺癌(NSCLC)患者的近期疗效及对细胞免疫、血清细胞角蛋白19片段(CYFRA21-1)、血管生成素-2(Ang-2)、血管内皮生长因子(VEGF)的影响。方法:选取2018年1月至2020年12月我院收治的中晚期NSCLC患者102例,简单随机将患者分为联合组与对照组,各51例。对照组给予化疗方案治疗,联合组在其基础上联合卡瑞利珠单抗治疗。比较两组近期疗效、治疗前后细胞免疫功能(NK、CD3^(+)、CD4^(+)/CD8^(+))、血清肿瘤标志物[CYFRA21-1、癌胚抗原(CEA)、肿瘤抗原125(CA125)、神经特异性烯醇化酶(NSE)]以及血管新生指标(Ang-2、VEGF)。结果:治疗后联合组近期临床疗效的总有效率为64.706%,显著高于对照组的33.333%(P<0.05)。治疗后,两组患者的NK、CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均降低,且联合组患者的水平高于对照组(P<0.05);两组患者CYFRA21-1、CEA、CA125及NSE水平均降低,且联合组水平显著低于对照组(P<0.05);两组患者的Ang-2和VEGF的含量均降低,联合组Ang-2和VEGF含量分别达到(1 194.07±156.37)pg/mL、(308.77±107.66)pg/mL,显著低于对照组的(1 266.34±146.17)pg/mL、(355.74±119.38)pg/mL(P<0.05)。结论:卡瑞利珠单抗辅助化疗对中晚期NSCLC患者的近期疗效确切,且能减轻对免疫功能的影响,显著改善血清肿瘤标志物水平并对血管新生起到一定的抑制作用。

Objective:To observe the short-term efficacy of camrelizumab in adjuvant chemotherapy for patients with advanced non-small cell lung cancer(NSCLC),and the influence on cellular immunity, serum cytokeratin 19 fragment(CYFRA21-1),angiopoietin-2(Ang-2) and vascular endothelial growth factor(VEGF).Methods:A total of 102 patients with advanced NSCLC admitted to the hospital from January 2018 to December 2020 were selected, and randomly divided into combination group and control group, with 51 cases in each group.Patients in the control group were treated with chemotherapy, and those in the combination group were treated with camrelizumab on this basis.The two groups were compared in terms of short-term efficacy, cellular immune function(NK,CD3^(+)and CD4^(+)/CD8^(+)),serum tumor markers [CYFRA21-1,carcinoembryonic antigen(CEA),cancer antigen 125(CA125) and nerve-specific enolase(NSE)] and angiogenesis indicators(Ang-2 and VEGF).Results:The total clinical effective rate of treatment in the combined group(64.706%) was significantly higher than that in the control group(33.333%)(P<0.05).After treatment, the levels of NK,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were decreased in the two groups, but higher in the combination group than in the control group(P<0.05).The levels of CYFRA21-1,CEA,CA125 and NSE were decreased in the two groups, and lower in the combination group than in the control group(P<0.05).The levels of Ang-2 and VEGF were decreased in the two groups.The levels of Ang-2 and VEGF in the combined group were(1 194.07±156.37) pg/mL and(308.77±107.66) pg/mL,significantly lower than(1 266.34±146.17) pg/mL and(355.74±119.38) pg/mL in the control group(P<0.05).Conclusion:Camrelizumab used for adjuvant chemotherapy can reduce the impact on immune function in patients with advanced NSCLC,significantly improve the levels of serum tumor markers and inhibit angiogenesis to a certain extent.