PD-1抑制剂联合化疗治疗晚期胃癌的临床效果及毒副反应分析

Analysis of clinical effects and toxic side effects of PD-1 inhibitors combined with chemotherapy in the treatment of advanced gastric cancer

目的探究程序性细胞死亡蛋白-1(PD-1)抑制剂联合化疗治疗晚期胃癌的临床效果及毒副反应。方法70例晚期胃癌患者,根据治疗方法不同分为参照组及研究组,每组35例。参照组实施化疗治疗,研究组实施PD-1抑制剂联合化疗治疗。比较两组疾病控制率、毒副反应发生情况及治疗前后免疫功能[免疫球蛋白A(IgA)、CD4^(+)/CD8^(+)]、肿瘤标志物[糖类抗原199(CA199)、癌胚抗原(CEA)及糖类抗原125(CA125)]水平。结果研究组疾病控制率80.00%明显高于参照组的57.14%,差异有统计学意义(P<0.05)。治疗后,两组患者IgA、CD4^(+)/CD8^(+)均低于本组治疗前,但研究组患者IgA(2.98±0.82)g/L、CD4^(+)/CD8^(+)(0.92±0.25)均高于参照组的(2.34±0.68)g/L、(0.78±0.21),差异具有统计学意义(P<0.05)。治疗后,研究组患者CEA(4.17±1.64)ng/ml、CA199(31.81±7.56)U/ml、CA125(18.16±4.98)U/ml均低于参照组的(14.32±3.73)ng/ml、(41.27±6.73)U/ml、(28.17±4.87)U/ml,差异具有统计学意义(P<0.05)。两组患者骨髓抑制、皮疹、腹泻、高血糖、甲状腺功能减退症(甲减)发生率比较,差异无统计学意义(P>0.05)。结论晚期胃癌患者采用PD-1抑制剂联合化疗治疗,可缓解临床症状,减轻免疫抑制,改善血清肿瘤标志物水平,且疾病控制率有效提高,毒副反应少,安全性高,治疗效果显著。

Objective To investigate the clinical effect and toxic side effects of programmed death-1(PD-1)inhibitors combined with chemotherapy in the treatment of advanced gastric cancer.Methods A total of 70 patients with advanced gastric cancer were divided into a reference group and a research group according to different treatment method,with 35 cases in each group.The reference group was treated with chemotherapy,and the research group was treated with PD-1 inhibitor and chemotherapy.Both groups were compared in terms of disease control rate,occurrence of toxic side effects and immune function[immunoglobulin A(IgA),CD4^(+)/CD8^(+)],tumor markers[carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA)and cancer antigen 125(CA125)]levels before and after treatment.Results The disease control rate 80.00%in the research group was significantly higher than 57.14%in the reference group,and the difference was statistically significant(P<0.05).After treatment,the IgA and CD4^(+)/CD8^(+)in both groups were lower than those before treatment in this group,but the IgA(2.98±0.82)g/L and CD4^(+)/CD8^(+)(0.92±0.25)in the research group were higher than(2.34±0.68)g/L and(0.78±0.21)in the reference group.The differences were statistically significant(P<0.05).After treatment,the CEA(4.17±1.64)ng/ml,CA199(31.81±7.56)U/ml,and CA125(18.16±4.98)U/ml in the research group were lower than(14.32±3.73)ng/ml,(41.27±6.73)U/ml,and(28.17±4.87)U/ml in the reference group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of bone marrow suppression,rash,diarrhea,hyperglycemia,and hypothyroidism between the two groups(P>0.05).Conclusion PD-1 inhibitor combined with chemotherapy has significant therapeutic effect for advanced gastric cancer patients,and can alleviate clinical symptoms,reduce immunosuppression,improve the level of serum tumor markers,and effectively improve the disease control rate,with less toxic side effects and high safety.