摘要
目的探讨信迪利单抗联合奥沙利铂及替吉奥(tegafur gimeracil oteracil potassium,SOX)应用于可切除胃癌围手术期患者的效果。方法选取2021年4月—2023年12月收治的胃癌患者108例纳入研究,根据围手术期化疗方案不同,仅使用SOX方案的50例为SOX组,使用信迪利单抗联合SOX的58例为联合组。比较2组的临床疗效[客观缓解率(objective response rate,ORR)和疾病控制率(disease control rate,DCR)、主要病理缓解(major pathological response,MPR)和完全病理缓解率(pathological complete response,pCR)]和肿瘤退缩分级;比较2组治疗前后的组织标志物(细胞CD4^(+)和CD8^(+)细胞)表达率、血清生物标志物[癌胚抗原(carcinoembryonic antigen,CEA)和胃蛋白酶原Ⅰ(pepsinogenⅠ,PGⅠ)/PGⅡ]水平的变化,评估化疗药物的安全性和手术安全性。结果联合组的DCR、ORR和pCR均高于SOX组(P<0.05),MPR与SOX组比较差异无统计学意义(P>0.05);手术后,联合组的肿瘤退缩分级为0级、1级和2级患者的占比与SOX组比较差异有统计学意义(P<0.05),3级与SOX组比较差异无统计学意义(P>0.05);治疗后,联合组的组织标志物CD4^(+)和CD8^(+)细胞阳性表达率均上升,SOX组的组织标志物阳性表达率均降低,2组的CEA水平均降低,PGⅠ/PGⅡ值均上升,2组比较差异有统计学意义(P<0.05);2组不良反应和手术安全事件发生率比较差异均无统计学意义(P>0.05)。结论信迪利单抗联合SOX可明显提升可切除胃癌围手术期患者的ORR和pCR,促进肿瘤退缩,降低肿瘤标志物水平,提高免疫力,化疗药物安全性和手术安全性均较好。
Objective To investigate the application effect of sintilimab combined with oxaliplatin and tegafur gimeracil oteracil potassium(SOX)in perioperative patients with resectable gastric cancer.Methods A total of 108 patients with gastric cancer admitted from April 2021 to December 2023 were selected and included in the study.According to different perioperative chemotherapy regimens,50 patients who only received SOX regimen were included in SOX group,and the other 58 patients who received sintilimab combined with SOX were enrolled as combined group.The clinical efficacy[objective response rate(ORR)and disease control rate(DCR),major pathological response(MPR)and pathological complete response(pCR)]and tumor regression grading and expression rates of tissue markers(CD4^(+)cell and CD8^(+)cell)and the levels of serum biomarkers[carcinoembryonic antigen(CEA)and pepsinogenⅠ(PGⅠ)/PGⅡ]before and after treatment were compared between groups.The chemotherapeutic drug safety and surgical safety were evaluated.Results DCR,ORR and pCR in the combined group were higher than those in the SOX group(P<0.05),but MPR was not statistically different from that in the SOX group(P>0.05).After surgery,there were statistical differences in the proportions of patients with tumor regression grade 0,grade 1 and grade 2 in the combined group compared with in the SOX group(P<0.05),but there was no significant difference in the proportion of grade 3 compared with that in the SOX group(P>0.05).After treatment,the positive expression rates of CD4^(+)and CD8^(+)cells were increased in the combined group,and the positive expression rates of tissue markers were declined in the SOX group,and the CEA levels in both groups were reduced,while PG-Ⅰ/PG-Ⅱ was enhanced,and the differences between the 2 groups were statistically significant(P<0.05).There was no statistical difference in the incidence rates of adverse drug reactions and surgical safety events between the 2 groups(P>0.05).Conclusion Sintilimab combined with SOX has an exact effect in improving ORR and pCR in perioperative patients with resectable gastric cancer,which can promote tumor regression,reduce the levels of tumor markers and enhance the immunity,with good drug safety and surgical safety.
作者
刘涛
常伟龙
魏重庆
张谢夫
LIU Tao;CHANG Weilong;WEI Chongqing;ZHANG Xiefu(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《西北药学杂志》
2025年第4期124-130,共7页
Northwest Pharmaceutical Journal
基金
河南省青年人才托举工程项目(编号:2021HYTP058)。
关键词
胃癌
信迪利单抗
奥沙利铂
替吉奥
围手术期
gastric cancer
sintilimab
oxaliplatin
tegafur gimeracil oteracil potassium
perioperative period
