摘要
目的探究阿替利珠单抗与信迪利单抗治疗中晚期非小细胞肺癌的疗效及对患者细胞角蛋白19的可溶性片段(CYFRA21-1)、糖类抗原125(CA125)的影响。方法研究对象为我院收治的67例中晚期非小细胞肺癌患者,所选取年限为2021年1月~2023年1月,按照研究方法不同分为对照组32例(信迪利单抗治疗)和观察组35例(阿替利珠单抗治疗)。对比两组患者细胞生长因子[血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)、基质金属蛋白酶-9(MMP-9)]、肿瘤标志物[CA125、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)]、CYFRA21-1、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平及不良反应发生情况。结果治疗后,两组MMP-9、VEGF、bFGF水平均较本组治疗前降低,且观察组MMP-9(312.22±27.68)mg/ml、VEGF(169.62±19.65)pg/ml、bFGF(14.89±3.19)ng/L较对照组的(335.84±31.90)mg/ml、(185.47±20.82)pg/ml、(17.11±3.24)ng/L更低,有统计学差异(P<0.05)。治疗后,两组CD8^(+)较本组治疗前下降,CD4^(+)/CD8^(+)、CD4^(+)较本组治疗前提高,且观察组CD8^(+)(21.23±2.08)%较对照组的(23.10±2.19)%更低,CD4^(+)/CD8^(+)(1.72±0.49)、CD4^(+)(38.02±4.01)%较对照组的(1.47±0.26)、(35.70±3.86)%更高,有统计学差异(P<0.05)。治疗后,两组CYFRA21-1水平较本组治疗前下降,且观察组较对照组CYFRA21-1水平(5.87±0.89 vs.7.54±1.0)ng/ml更低,有统计学差异(P<0.05)。治疗后,两组CA19-9、CA125、CEA水平较本组治疗前下降,且观察组CA19-9(32.28±5.77)U/ml、CA125(23.21±5.87)U/ml、CEA(8.43±0.60)μg/L较对照组的(35.65±5.32)U/ml、(26.86±6.12)U/ml、(9.13±0.75)μg/L更低,有统计学差异(P<0.05)。观察组较对照组提高肝功能异常发生率,而降低胃肠道反应、骨髓抑制、腹泻发生率,但无统计学差异(P>0.05)。结论中晚期非小细胞肺癌患者使用阿替利珠单抗与信迪利单抗治疗后,细胞因子和肿瘤标志物水平均得到改善,免疫功能升高,CYFRA21-1水平下调,其中阿替利珠单抗的临床效果更显著。
Objective To investigate the effect of atezolizumab and sintilimab in treating locally advanced non-small cell lung cancer and their impact on patients'soluble fragment of cytokeratin 19(CYFRA21-1)and carbohydrate antigen 125(CA125)levels.Methods The study included 67 patients with locally advanced or metastatic non-small cell lung cancer admitted to our hospital between January 2021 and January 2023.Based on treatment modality,patients were divided into a control group(n=32)receiving sintilimab therapy and an observation group(n=35)receiving atezolizumab therapy.The two groups were compared for levels of cell growth factors[vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),matrix metalloproteinase-9(MMP-9)],tumor markers[CA125,carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)],CYFRA21-1,immune function indicators(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),and adverse reaction incidence.Results After treatment,the levels of MMP-9,VEGF and bFGF in both groups were lower than those before treatment in this group.Moreover,the observation group had MMP-9 of(312.22±27.68)mg/ml,VEGF of(169.62±19.65)pg/ml,and bFGF of(14.89±3.19)ng/L,which were lower than those in the control group[(335.84±31.90)mg/ml,(185.47±20.82)pg/ml,and(17.11±3.24)ng/L],with a statistically significant difference(all P<0.05).Following treatment,CD8^(+)cells decreased in both groups compared to pre-treatment levels,while CD4^(+)/CD8^(+)and CD4^(+)cells increased.The observation group exhibited lower CD8^(+)levels(21.23±2.08)%than the control group(23.10±2.19)%,while the CD4^(+)/CD8^(+)ratio(1.72±0.49)and CD4^(+)percentage(38.02±4.01)were higher than those in the control group(1.47±0.26 and 35.70±3.86%,respectively),with statistically significant differences(P<0.05).After treatment,CYFRA21-1 levels decreased in both groups compared to pre-treatment levels.The observation group exhibited significantly lower CYFRA21-1 levels(5.87±0.89 vs.7.54±1.0 ng/ml)than the control group,with statistical significance(P<0.05).Following treatment,CA19-9,CA125,and CEA levels decreased in both groups compared to pre-treatment levels.The observation group exhibited significantly lower CA19-9(32.28±5.77)U/ml,CA125(23.21±5.87)U/ml,and CEA(8.43±0.60)μg/L were significantly lower than those in the control group(35.65±5.32)U/ml,(26.86±6.12)U/ml,and(9.13±0.75)μg/L in the control group,representing statistically significant differences(P<0.05).The observation group showed a higher incidence of abnormal liver function compared to the control group,while exhibiting lower rates of gastrointestinal reactions,bone marrow suppression,and diarrhea;however,these differences were not statistically significant(P>0.05).Conclusion After treatment with atezolizumab or sintilimab,the levels of cytokines and tumor markers in patients with locally advanced non-small cell lung cancer have improved,immune function has increased,and the level of CYFRA21-1 has been downregulated,with atezolizumab exhibiting more pronounced clinical efficacy.
作者
刘婷
周凯
LIU Ting;ZHOU Kai(Department of Oncology,Donghai County People's Hospital,Lianyungang 222300,China)
出处
《中国现代药物应用》
2026年第1期10-14,共5页
Chinese Journal of Modern Drug Application
