信迪利单抗联合白蛋白结合型紫杉醇和顺铂对晚期非小细胞肺癌治疗效果及对T淋巴细胞亚群的影响

Curative Effect of Sintilimab Combined with Albumin Bound Paclitaxel and Cisplatin on Advanced Non-Small Cell Lung Cancer and Its Effect on T Lymphocyte Subsets

目的研究信迪利单抗联合白蛋白结合型紫杉醇和顺铂治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的效果。方法选取2020年1月—2022年12月本院收治的84例晚期NSCLC患者,根据随机数字表法分成两组,每组各42例。对照组患者接受白蛋白结合型紫杉醇联合顺铂治疗,观察组患者在此基础上接受信迪利单抗治疗,均治疗3月。比较两组临床疗效,肿瘤标志物(癌胚抗原、细胞角蛋白19片段、糖类抗原199)、T淋巴细胞亚群及不良反应发生率。结果观察组治疗总缓解率、总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组血清肿瘤标志物水平显著降低,且观察组低于对照组(P<0.05);治疗后,两组CD4+升高,CD8+降低,CD4+/CD8+比值升高,且观察组改变率高于对照组(P<0.05),两组不良反应发生率无显著差异(P>0.05)。结论信迪利单抗联合白蛋白结合型紫杉醇和顺铂治疗晚期NSCLC的效果好,能有效降低血清肿瘤标志物,改善免疫水平,值得临床推广。

Objective To investigate effect of Sintilimab combined with albumin bound paclitaxel and cisplatin in treatment of advanced non-small cell lung cancer(NSCLC).Methods The paper chose 84 patients with advanced NSCLC admitted to our hospital from January 2020 to December 2022,and divided them into two groups randomly,with 42 cases in each group.Control group was treated with albumin bound paclitaxel combined with cisplatin treatment,while observation group with cisplatin treatment on this basis for 3 months.Clinical effect,tumor markers(carcinoembryonic antigen,cytokeratin 19 fragment,carbohydrate antigen 199),T lymphocyte subsets,and incidence of adverse reactions were compared between two groups.Results Total remission rate and effective rate of observation group was 40.48% and 85.71%,higher than 19.05% and 66.67%of control group,difference was statistically significant(P=0.032,P=0.040).After treatment,levels of serum tumor markers in two groups significantly decreased,those of observation group were lower than control group(P<0.05).After treatment,CD4+ increased,CD8+ decreased,CD4+/CD8+ ratio increased in both groups.Change rate in observation group was higher than control group(P<0.05),there was no significant difference in incidence of adverse reactions between two groups(P>0.05).Conclusion Combination of Sintilimaband albumin bound paclitaxel and cisplatin is effective in treatment of advanced NSCLC,can effectively reduce serum tumor markers and improve immune levels,which is worthy of clinical promotion.