程序性死亡受体1抑制剂在慢性阻塞性肺疾病合并非小细胞肺癌患者中的应用效果

Effect of programmed cell death 1 inhibitor in patients with chronic obstructive pulmonary disease combined with non-small cell lung cancer

目的探讨程序性死亡受体1(PD-1)抑制剂在慢性阻塞性肺疾病(COPD)合并非小细胞肺癌(NSCLC)患者中的应用效果,并观察其对患者免疫功能、生活质量的影响。方法根据治疗方案的不同将90例COPD合并NSCLC患者分为对照组(n=50)和观察组(n=40),对照组患者给予多西他赛+顺铂化疗,观察组患者给予纳武利尤单抗联合多西他赛+顺铂化疗。比较两组患者的临床疗效、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、肿瘤标志物[糖类抗原125(CA125)、癌胚抗原(CEA)]水平、生活质量[卡氏功能状态(KPS)评分]和不良反应发生情况。结果观察组患者的客观缓解率为72.00%,高于对照组患者的50.00%,差异有统计学意义(P<0.05)。治疗后,观察组不同TNM分期患者CD3^(+)、CD4^(+)水平和CD4^(+)/CD8^(+)均高于对照组,CD8^(+)、CA125、CEA水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组不同TNM分期患者KPS评分及总改善率均高于本组治疗前,观察组患者KPS评分及总改善率均高于对照组,差异均有统计学意义(P<0.05)。观察组患者不良反应总发生率为14.00%,与对照组患者的30.00%比较,差异无统计学意义(P>0.05)。结论PD-1抑制剂治疗COPD合并NSCLC患者的疗效显著,可改善患者的免疫功能和生活质量,且不增加不良反应发生风险。

Objective To investigate the application effect of programmed cell death 1(PD-1)inhibitor in patients with chronic obstructive pulmonary disease(COPD)combined with non-small cell lung cancer(NSCLC),and to observe its impact on patients’immune function and quality of life.Method A total of 90 patients with COPD combined with NSCLC were divided into control group(n=50)and observation group(n=40)according to different treatment regimens.Patients in the control group were given docetaxel+cisplatin chemotherapy,and patients in the observation group were given nivolumab combined with docetaxel+cisplatin chemotherapy.The clinical efficacy,immune function indicators(CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)),tumor markers[carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)]levels,and quality of life[Karnofsky performance status(KPS)score],and the occurrence of adverse events were compared between the two groups.Result The objective response rate of the observation group was 72.00%,which was higher than 50.00%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the CD3^(+),CD4^(+)levels and CD4^(+)/CD8^(+)of the observation group with different TNM stage were higher than those of the control group,while the CD8^(+),CA125,and CEA levels of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After the treatment,the KPS scores and total improvement rates of the two groups with different TNM stage were higher than those before the treatment,the KPS scores and total response rate of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The total incidence rate of adverse events in the observation group was 14.00%,which was not significantly different from 30.00%in the control group(P>0.05).Conclusion PD-1 inhibitor could achieve remarkable efficacy in the treatment of patients with COPD and NSCLC,and improve their immune function and quality of life without increasing the risk of adverse events.