信迪利单抗对晚期非小细胞肺癌患者T淋巴细胞亚群的影响及其治疗效果研究

Effect of sintilimab on Tlymphocyte subsets in patients with advanced non-small cell lung cancer and its therapeutic efficacy

目的探讨信迪利单抗对晚期非小细胞肺癌(NSCLC)患者T淋巴细胞亚群的影响及其治疗效果。方法根据治疗方法的不同将145例晚期NSCLC患者分为对照组(n=71)和观察组(n=74),对照组患者采用吉西他滨^(+)顺铂(GP)方案化疗,观察组患者在对照组的基础上给予信迪利单抗治疗。比较两组患者的临床疗效、T淋巴细胞亚群[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、调节性T细胞(Treg)、辅助性T细胞1(Th1)/辅助性T细胞2(Th2)]、肿瘤标志物[血清铁蛋白(SF)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCCA)、癌胚抗原(CEA)]及不良反应发生情况。结果观察组患者的客观缓解率(ORR)为29.73%,与对照组患者的22.54%比较,差异无统计学意义(P﹥0.05)。观察组患者的疾病控制率(DCR)为63.51%,高于对照组患者的46.48%,差异有统计学意义(P﹤0.05)。治疗后,两组患者的CD4^(+)水平、CD4^(+)/CD8^(+)、Th1/Th2均高于本组治疗前,CD8^(+)、Treg水平均低于本组治疗前,观察组患者的CD4^(+)水平、CD4^(+)/CD8^(+)、Th1/Th2均高于对照组,CD8^(+)、Treg水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者的SF、NSE、SCCA、CEA水平均低于本组治疗前,观察组患者的SF、NSE、SCCA、CEA水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者的不良反应发生情况比较,差异无统计学意义(P﹥0.05)。结论信迪利单抗治疗晚期NSCLC患者能够改善机体的免疫功能,降低肿瘤标志物水平,有助于提升疾病控制效果,且具有一定的安全性。

Objective To investigate the effect of sintilimab on T lymphocyte subsets in patients with advanced nonsmall cell lung cancer(NSCLC)and its therapeutic efficacy.Method A total of 145 patients with advanced NSCLC were divided into control group(n=71)and observation group(n=74)according to different treatment methods.The pa‐tients in the control group were treated with gemcitabine^(+)cisplatin(GP)chemotherapy,and the patients in the observation group were treated with sintilimab based on the control group.The clinical efficacy,T lymphocyte subsets[CD4^(+),CD8^(+),CD4^(+)/CD8^(+),regulatory T cells(Treg),helper T cell 1(Th1)/helper T cell 2(Th2)],tumor markers[serum ferritin(SF),neuron specific enolase(NSE),squamous cell carcinoma antigen(SCCA)and carcinoembryonic antigen(CEA)],and ad‐verse reactions were compared between the two groups.Result The objective response rate(ORR)in the observation group was 29.73%,compared with 22.54%in the control group,the difference was not statistically significant(P>0.05).The disease control rate(DCR)of the observation group was 63.51%,higher than 46.48%of the control group,and the difference was statistically significant(P<0.05).After the treatment,the CD4^(+)levels,CD4^(+)/CD8^(+),and Th1/Th2 in the two groups were higher than those before treatment,and the CD8^(+)and Treg levels were lower than those before the treatment,the CD4^(+)level,CD4^(+)/CD8^(+),and Th1/Th2 in the observation group were higher than those in the control group,and the CD8^(+)and Treg levels in the observation group were lower than those in the control group,and the differences were statis‐tically significant(P<0.05).After the treatment,the levels of SF,NSE,SCCA,and CEA in the two groups were lower than those before the treatment,and the levels of the above indexes in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the inci‐dence of adverse events between the two groups(P>0.05).Conclusion Sintilimab in the treatment of patients with ad‐vanced NSCLC could improve the immune function of the body,reduce the levels of tumor markers,and help to improve the disease control with certain safety.