程序性死亡蛋白1抑制剂联合化疗对晚期胃癌患者的临床治疗价值观察

Clinical value of programmed death protein 1 inhibitor combined with chemotherapy in patients with advanced gastric cancer

目的 分析程序性死亡蛋白1(PD-1)抑制剂联合化疗用于晚期胃癌的效果及安全性,为临床提供参考。方法 按随机数字表法将2020年12月至2023年1月金坛区中医医院收治的78例晚期胃癌患者分为对照组和观察组,各39例。对照组患者给予奥沙利铂联合替吉奥常规化疗治疗,观察组患者在对照组的基础上加用信迪利单抗治疗。比较两组患者临床疗效、肿瘤标记物[癌胚抗原(CEA)、糖类抗原125(CA125)及糖类抗原199(CA199)]水平、免疫功能指标水平及不良反应发生情况。结果 观察组患者整体临床疗效优于对照组(P<0.05)。治疗后,两组患者CEA、CA125及CA199水平较治疗前降低,且观察组低于对照组(P<0.05)。治疗后,两组患者CD3^(+)T淋巴细胞百分比、CD4^(+)T淋巴细胞百分比及CD4^(+)/CD8^(+)比值较治疗前降低,CD8^(+)T淋巴细胞百分比较治疗前升高,但观察组患者CD3^(+)T淋巴细胞百分比、CD4^(+)T淋巴细胞百分比及CD4^(+)/CD8^(+)比值高于对照组,CD8^(+)T淋巴细胞百分比低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 PD-1抑制剂联合化疗用于晚期胃癌的效果显著,可进一步降低患者肿瘤标记物水平,改善免疫功能,且安全性良好,值得临床应用。

Objective To analyze the efficacy and safety of programmed death protein 1(PD-1)inhibitor combined with chemotherapy in the treatment of advanced gastric cancer,and to provide clinical reference.Methods 78 patients with advanced gastric cancer admitted to Jintan District Hospital of Traditional Chinese Medicine from December 2020 to January 2023 were selected as the study objects,and were divided into control group and observation group according to random number table method,with 39 cases in each group.Patients in the control group were treated with oxaliplatin combined with conventional chemotherapy of tegafur,and patients in the observation group were treated with sintilimab on the basis of the control group.The clinical efficacy,levels of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and carbohydrate antigen 199(CA199)],levels of immune function indices and occurrence of adverse reactions were compared between the two groups.Results The overall clinical efficacy of the observation group was better than that of the control group(P<0.05).After treatment,the levels of CEA,CA125 and CA199 in the two groups were lower than before treatment,and the levels of these tumor markers of the observation group were lower than those of the control group(P<0.05).After treatment,the percentage of CD3+T lymphocytes,the percentage of CD4+T lymphocytes and the ratio of CD4+/CD8+in the two groups were lower than those before treatment,and the percentage of CD8+T lymphocytes was higher than before treatment,but the percentage of CD3+T lymphocytes,the percentage of CD4+T lymphocytes and the ratio of CD4+/CD8+in the observation group were higher than those in the control group,and the percentage of CD8+T lymphocytes was lower than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion PD-1 inhibitor combined with chemotherapy has a significant effect in the treatment of advanced gastric cancer,which can further reduce the level of tumor markers in patients and improve immune function,and has good safety,which is worthy of clinical application.