摘要
目的探究卡瑞利珠单抗(SHR-1210)联合化疗对晚期胃癌患者治疗效果及瘤内微生物群的影响。方法选取2020年4月—2021年5月收治的92例晚期胃癌,根据治疗方法不同均分为研究组和对照组,研究组接受SHR-1210联合化疗,对照组接受化疗。比较2组治疗效果,治疗前后血清癌胚抗原(CEA)、癌抗原19-9(CA19-9)水平,治疗后瘤内微生物群检出率、自然杀伤细胞(NK细胞)、T淋巴细胞亚群水平,以及不良反应和随访2年无进展生存率、总生存率。结果治疗后,研究组总有效率为89.1%(41/46)高于对照组的56.5%(26/46)(P<0.01)。治疗后,研究组血清CEA、CA19-9水平、瘤内微生物群检出率、CD8+及NK细胞水平低于对照组(P<0.05,P<0.01)。治疗后,研究组CD4+、CD4+/CD8+水平高于对照组,随访2年无进展生存率、总生存率高于对照组(P<0.05,P<0.01)。研究组不良反应总发生率低于对照组(P<0.01)。结论SHR-1210联合化疗可降低晚期胃癌患者血清CEA、CA19-9水平,减少瘤内微生物群,大幅度提高治疗安全性,改善预后,效果显著。
Objective To explore the effects of carrilizumab(SHR-1210)combined with chemotherapy on the therapeutic efficacy and intratumoral microbiota in patients with advanced gastric cancer.Methods In total,92 patients with advanced gastric cancer treated from April 2020 to May 2021 were selected and divided into research group and control group according to different treatment methods.The research group received SHR-1210 combined chemotherapy,and the control group received chemotherapy.The therapeutic effect,the levels of serum carcinoembryonic antigen(CEA)and cancer antigen 19-9(CA19-9)before and after treatment,detection rate of intratumoral microbiota after treatment,natural killer(NK)cells and T lymphocyte subsets after treatment,as well as adverse reactions,2-year progression-free survival(PFS)and overall survival(OS)were compared between the two groups.Results After treatment,the total effective rate was 89.1%(41/46)in the research group,which was higher than that[56.5%(26/46)]in the control group(P<0.01).After treatment,the levels of serum CEA,CA19-9,detection rate of intratumoral microbiome,CD8+and NK cells in the research group were lower than those in the control group(P<0.05,P<0.01).After treatment,the levels of CD4+and CD4+/CD8+in the research group were higher than those in the control group,and the 2-year PFS rate and OS rate were higher than those in the control group(P<0.05,P<0.01).The total incidence of adverse reactions in the research group was lower than that in the control group(P<0.01).Conclusion SHR-1210 combined with chemotherapy can reduce the levels of serum CEA and CA19-9 in patients with advanced gastric cancer,reduce the intratumoral microbiota,greatly improve the safety of treatment,and improve the prognosis,showing significant effects.
作者
张迪
戴领
张博亚
王英杰
郭琳娜
徐福田
ZHANG Di;DAI Ling;ZHANG Boya;WANG Yingjie;GUO Linna;XU Futian(Department of General Practice,the People's Hospital of Langfang City,Langfang,Hebei 065000,China;Department of General Surgery,the People's Hospital of Langfang City,Langfang,Hebei 065000,China)
出处
《临床误诊误治》
CAS
2023年第12期32-36,共5页
Clinical Misdiagnosis & Mistherapy
基金
2021年度河北省卫生健康委员会计划项目(20221595)。
关键词
胃肿瘤
晚期
卡瑞利珠单抗
化疗
癌胚抗原
癌抗原19-9
瘤内微生物群
预后
Gastric neoplasms
Late stage
Carrilizumab
Chemotherapy
Carcinoembryonic antigen
Cancer antigen 19-9
Intratumoral microbiota
Prognosis
