替雷利珠单抗联合培美曲塞和顺铂治疗Ⅳ期非小细胞肺癌患者的效果

Effects of Tislelizumab combined with Pemetrexed and Cisplatin in treatment of patients with stage IV non-small cell lung cancer

目的:观察替雷利珠单抗联合培美曲塞和顺铂治疗Ⅳ期非小细胞肺癌患者的效果。方法:选取2020年8月至2023年8月该院收治的102例Ⅳ期非小细胞肺癌患者进行前瞻性研究,按照随机数字表法分为研究组与对照组各51例。对照组采用培美曲塞联合顺铂治疗,研究组在对照组基础上增加替雷利珠单抗注射液治疗。比较两组客观缓解率、血清肿瘤标志物[血管内皮生长因子(VEGF)、神经元特异性烯醇化酶(NSE)、细胞角蛋白21-1片段(CYFRA21-1)、糖类抗原125(CA125)、癌胚抗原(CEA)]水平、T细胞亚群指标(CD3^(+)、CD4^(+)、CD8^(+))水平和不良反应发生率。结果:研究组客观缓解率为96.08%,明显高于对照组的84.31%,差异有统计学意义(P<0.05);治疗后,两组VEGF、NSE、CYFRA21-1、CA125、CEA等血清肿瘤标志物水平低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05);治疗后,两组CD3^(+)、CD4^(+)水平低于治疗前,但研究组高于对照组,两组CD8水平高于治疗前,但研究组低于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:替雷利珠单抗联合培美曲塞和顺铂治疗Ⅳ期非小细胞肺癌患者可提高客观缓解率,改善T细胞亚群指标水平,降低肿瘤标志物水平,效果优于单纯培美曲塞和顺铂治疗。

Objective:To observe effects of Tislelizumab combined with Pemetrexed and Cisplatin in treatment of patients with stage IV non-small cell lung cancer.Methods:A prospective study was conducted on 102 patients with stage IV non-small cell lung cancer admitted to this hospital from August 2020 to August 2023.According to the random number table method,they were divided into study group and control group,51 cases in each group.The control group was treated with Pemetrexed combined with Cisplatin,while the study group was treated with Tislelizumab injection on the basis of the control group.The objective remission rate,the serum tumor markers[vascular endothelial growth factor(VEGF),neuron-specific enolase(NSE),cytokeratin 21-1 fragment(CYFRA21-1),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)]levels,the T cell subsets indicators(CD3^(+),CD4^(+),CD8^(+))levels,and the incidence of adverse reactions were compared between the two groups.Results:The objective remission rate of the study group was 96.08%,which was significantly higher than 84.31%of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of serum VEGF,NSE,CYFRA21-1,CA125,CEA and other serum tumor markers in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of CD3^(+) and CD4^(+) in the two groups were lower than+those before the treatment,but those in the study group were higher than those in the control group;the level of CD8^(+) in the two groups was higher than that before the treatment,but that in the study group was lower than the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Tislelizumab combined with Pemetrexed and Cisplatin in the treatment of the patients with stage IV non-small cell lung cancer can improve the objective response rate,improve the levels of T cell subsets,and reduce the levels of tumor markers.Moreover,it is superior to simple Pemetrexed and Cisplatin treatment.