信迪利单抗联合化疗治疗晚期食管癌患者疗效及对血清VEGF、TGF-β1水平的影响

Curative effect of sintilimab combined with chemotherapy and its influences on serum VEGF and TGF⁃β1 in patients with advanced esophageal cancer

目的 探讨信迪利单抗联合化疗治疗晚期食管癌(EC)患者疗效及对血清血管内皮生长因子(VEGF)、转化生长因子(TGF-β1)水平的影响。方法 选取2020年5月至2022年5月云南省肿瘤医院确诊的120例晚期EC患者,采用随机分组分为观察组(n=60)和对照组(n=60)。对照组采用紫杉醇+氟尿嘧啶+顺铂注射液治疗,观察组在对照组的基础上加以信迪利单抗治疗,均治疗3个周期。比较两组临床疗效、血清VEGF、TGF-β1水平、血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原199(CA199)、糖蛋白抗原50(CA50)]水平、功能状态评分、不良反应发生率。随访1年,比较两组生存情况。结果 治疗后,观察组晚期EC患者的客观缓解率和疾病控制率高于对照组,差异有统计学意义(P<0.05);治疗后,两组的VEGF、TGF-β1水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组的CEA、CA199、CA50水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组的卡氏功能状态评分高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组晚期EC患者的骨髓抑制、肌肉酸痛、胃肠道不适和肝功能损伤等总不良反应发生率比较差异无统计学意义(P>0.05)。随访1年,观察组生存46例,死亡14例;对照组生存35例、死亡25例,两组生存情况比较差异有统计学意义(χ^(2)=4.596,P=0.032)。结论 信迪利单抗联合化疗可提高晚期EC患者的临床疗效和功能状态,降低患者血清VEGF、TGF-β1水平。

Objective To explore the curative effect of sintilimab combined with chemotherapy and its influences on levels of serum vascular endothelial growth factor(VEGF)and transforming growth factorβ1(TGF-β1)in patients with advanced esophageal cancer(EC).Methods A total of 120 patients with ad-vanced EC confirmed at Yunnan Cancer Hospital were enrolled between May 2020 and May 2022.Using a ran-dom grouping method,they were divided into an observation group(n=60)and a control group(n=60).The control group received treatment with paclitaxel+fluorouracil+cisplatin,while the observation group received additional treatment with sintilimab.All patients underwent 3 cycles of treatment.The clinical curative effect,levels of serum VEGF,TGF-β1,tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),carbohydrate antigen 50(CA50)],score of Karnofsky performance status(KPS)scores,and inci-dence of adverse reactions were compared between the two groups.After 1 year of follow-up,the survival status of the patients in both groups was compared.Results After treatment,the objective response rate and disease control rate in the observation group were higher than those in the control group(P<0.05).After treatment,lev-els of VEGF and TGF-β1 in both groups decreased,with lower levels observed in the observation group com-pared to the control group(P<0.05).Levels of CEA,CA199,and CA50 also decreased,with the observation group showing lower levels than the than control group(P<0.05).Furthermore,KPS scores increased,with higher scores in the observation group compared to the control group(P<0.05).There was no significant differ-ence in the total incidence of adverse reactions(bone marrow suppression,muscle soreness,gastrointestinal dis-comfort,liver function injury)between the two groups(P>0.05).After 1 year of follow-up,there were 46 sur-vival cases and 14 death cases in the observation group,while there were 35 survival cases and 25 death cases in the control group.The difference in survival status between the two groups was statistically significant(χ^(2)=4.596,P=0.032).Conclusion Sintilimab combined with chemotherapy can improve clinical outcomes and functional status in patients with advanced EC.Additionally,it can reduce levels of serum VEGF and TGF-β1.