新辅助免疫检查点抑制剂联合安罗替尼与安罗替尼单药治疗非小细胞肺癌的疗效比较及对血清肿瘤标志物的影响

Comparison of efficacy of neoadjuvant immune checkpoint inhibitor combined with anlotinib and anlotinib monotherapy in patients with non-small cell lung cancer and effect on tumor markers

目的探究新辅助免疫检查点抑制剂联合安罗替尼与安罗替尼单药治疗非小细胞肺癌的疗效比较及对血清肿瘤标志物的影响。方法选取2018年4月至2020年4月在台州市中心医院(台州学院附属医院)住院治疗的120例非小细胞肺癌患者,根据随机数字表法分为对照组和研究组,每组60例。对照组患者给予安罗替尼单药治疗,研究组患者给予新辅助免疫检查点抑制剂(卡瑞丽珠单抗)联合安罗替尼治疗,对比两组患者的凝血功能有关指标、细胞角蛋白19片段(cytokeratin 19 fragment 21-1,CYFRA21-1)、癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原125(carbohydrate antigen,CA125)、免疫功能及不良反应发生情况。结果与对照组相比,研究组患者的活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、凝血酶时间(thrombin time,TT)等指标下降(P<0.05)。与治疗前比较,治疗1个月后两组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平升高,CD8^(+)、CEA、CYFRA21-1、CA125水平降低,且研究组低于对照组(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)。结论与安罗替尼单药治疗相比,卡瑞丽珠单抗联合安罗替尼可有效改善患者的凝血功能,调节血清肿瘤相关标志物水平,减轻非小细胞肺癌患者的症状,效果显著。

Objective To explore the efficacy of neoadjuvant immune checkpoint inhibitor combined with anlotinib and anlotinib monotherapy in patients with non-small cell lung cancer and the effect on tumor markers.Methods A total of 120 patients with non-small cell lung cancer hospitalized in Taizhou Central Hospital(Taizhou University Hospital)from April 2018 to April 2020 were selected and divided into control group and study group according to random number table method,with 60 cases in each group.Patients in control group were treated with monotherapy of anlotinib,while patients in study group were treated with neoadjuvant immune checkpoint inhibitors(Carilizumab)combined with anlotinib,compare the coagulation function related indicators,compared two groups of blood coagulation function in patients with relevant index and cytokeratin 19 fragment 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),immune function,and incidence of adverse reactions between two groups of patients.Results Compared with control group,activated partial thromboplastin time(APTT),vascular endothelial growth factor(VEGF),thrombin time(TT)levels were decreased(P<0.05).Compared with before treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in two groups increased,while the levels of CD8^(+),CEA,CYFRA21-1 and CA125 decreased in two groups after 1 month of treatment,and study group was lower than control group(P<0.05).There was no significant difference in the occurrence of adverse reactions between two groups(P>0.05).Conclusion Compared with anlotinib monotherapy,treatment with Carilizumab combined with anlotinib can effectively improve its coagulation function,regulate the level of serum tumor-related markers,and slow the symptoms of patients with mild non-small cell lung cancer,which provides a reference for clinical use.