卡瑞利珠单抗联合放化疗对局部晚期非小细胞肺癌患者生存预后的影响

Effects of Camrelizumab combined with chemoradiotherapy on the survival prognosis of patients with locally advanced NSCLC

目的 探讨卡瑞利珠单抗(Cam)联合放化疗对局部晚期非小细胞肺癌(NSCLC)患者血清程序性细胞死亡受体1(PD-1)、胸苷激酶1(TK1)、基质金属蛋白酶9(MMP-9)和生存预后的影响。方法 选取2018年6月—2020年6月徐州医科大学附属宿迁医院收治局部晚期NSCLC患者60例,并按照随机数表法分为研究组和对照组,每组各30例。研究组采取Cam联合放化疗治疗,对照组采取放化疗治疗,比较两组患者近期疗效情况和治疗前、治疗3个月时T细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))和血清PD-1、TK1、MMP-9水平,Kaplan-Meier法分析患者1年生存情况,记录不良反应。结果 治疗3个月时,研究组患者的疾病控制率(86.67%)、客观缓解率(53.33%)均高于对照组(63.33%、26.67%)(P<0.05);两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)较治疗前均呈升高趋势,且研究组高于对照组(P<0.05);血清PD-1、TK1、MMP-9水平较治疗前均呈降低趋势,且研究组低于对照组(P<0.05);两组患者1年疾病无进展生存期比较差异有统计学意义(Log-rankχ^(2)=4.040,P=0.040);两组患者治疗过程中不良反应比较,差异均无统计学意义(P>0.05)。结论 Cam联合放化疗提高局部晚期NSCLC近期疗效和免疫功能,降低血清PD-1、TK1、MMP-9水平,改善患者预后,安全性好。

Objective To explore the effects of Camrelizumab(Cam)combined with chemoradiotherapy on serum pro-grammed cell death 1(PD-1),thymidine kinase 1(TK1),matrix metalloproteinase-9(MMP-9)and thesurvival prognosis of patients with locally advanced non-small cell lung cancer(NSCLC).Methods 60 patients with locally advanced NSCLC admitted to the Af-filiated Suqian Hospital of Xuzhou Medical University from June 2018 to June 2020 were selected and divided into the study group and the control group according to the randomized number table method,with 30 cases in each group.Kaplan-Meier methodwas used to ana-lyze the 1-year survival of patientsand the adverse reactions were recorded.Results After 3 months of treatment,thedisease control rate(86.67%)and theobjective remission rate(53.33%)of the study group were higher thanthat of the control group(63.33%,26.67%,P<0.05).In both groups,levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were increased,compared with that of pretreatment,and the study group was higher than the control group(P<0.05).Serum PD-1,TK1,and MMP-9 levels all showed a decreasing trend compared with the pretreatment;that of the study group was lower than the control group(P<0.05).The difference in 1-year disease progression-free survival between the two groups was statistically significant(Log-rankχ^(2)=4.040,P=0.040).Comparison of adverse reactions during treatment between the two groups of patients,the differ-ence was not statistically significant(P>0.05).Conclusion Cam combined with chemoradiotherapy improvesrecentefficacyand im-mune functionof patients with locally advanced NSCLC,reduces levels of serum PD-1,TK1 and MMP-9,and improvesprognosis of with good safety.