摘要
目的:研究支气管镜下介入冷冻联合程序性细胞死亡蛋白-1(programmed death-1,PD-1)抑制剂治疗晚期肺癌患者的效果。方法:前瞻性选取2021年10月—2022年10月福建医科大学附属泉州第一医院收治的60例晚期肺癌患者。随机将其分为观察组及对照组,各30例。对照组给予PD-1抑制剂,观察组在对照组基础上给予支气管镜下介入冷冻治疗。比较两组临床疗效,治疗前后肿瘤指标、免疫功能、生活质量及毒副作用。结果:观察组临床疗效优于对照组,疾病总控制率(overall disease response rate,ORR)高于对照组,差异有统计学意义(P<0.05)。治疗后,两组糖类抗原125(carbohydrate antigen 125,CA125)、细胞角蛋白19片段抗原(cytokeratin 19 fragment antigen,CYFRA21-1)、癌胚抗原(carcinoembryonic antigen,CEA)水平均显著降低,观察组CA125、CYFRA21-1、CEA水平均显著低于对照组,差异有统计学意义(P<0.05)。治疗后,两组CD3^(+)、CD3^(+)/CD4^(+)、CD3^(+)/CD8^(+)、CD4^(+)/CD8^(+)均升高,CD4^(+)/CD125^(+)降低,观察组CD3^(+)、CD3^(+)/CD4^(+)、CD3^(+)/CD8^(+)、CD4^(+)/CD8^(+)均显著高于对照组,CD4^(+)/CD125^(+)低于对照组,差异有统计学意义(P<0.05)。治疗后,两组躯体、情绪、认知、角色和社会评分均升高,观察组躯体、情绪、认知、角色和社会评分均显著高于对照组,差异有统计学意义(P<0.05)。两组口腔黏膜炎、手足麻木、白细胞降低及血小板下降、蛋白尿、腹泻、恶心呕吐、肝功能异常发生率比较,差异无统计学意义(P>0.05)。结论:晚期肺癌患者采取支气管镜下介入冷冻联合PD-1抑制剂进行治疗,患者的免疫功能、肿瘤指标得到显著的改善,安全性较好,治疗效果显著。
Objective:To investigate the effect of interventional freezing under bronchoscopy combined with programmed death-1(PD-1)inhibitors in the treatment of patients with advanced lung cancer.Method:A total of 60 patients with advanced lung cancer admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from October 2021 to October 2022 were prospectively selected.They were randomly divided into observation group and control group,30 cases in each group.The control group was given PD-1 inhibitors.The observation group was given interventional freezing under bronchoscopy on the basis of control group.The clinical efficacy,tumor index,immune function,quality of life before and after treatment and toxicity were compared between the two groups.Result:The clinical efficacy of the observation group was better than that of the control group,and the overall disease response rate(ORR)was higher than that of the control group,the differences were statistically significant(P<0.05).After treatment,the levels of carbohydrate antigen 125(CA125),cytokeratin 19 fragment antigen(CYFRA21-1),and carcinoembryonic antigen(CEA)were significantly reduced in both groups,the levels of CA125,CYFRA21-1 and CEA in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,CD3^(+),CD3^(+)/CD4^(+),CD3^(+)/CD8^(+),CD4^(+)/CD8^(+)increased in both groups,while CD4^(+)/CD125^(+)decreased,CD3^(+),CD3^(+)/CD4^(+),CD3^(+)/CD8^(+),CD4^(+)/CD8^(+)in the observation group were significantly higher than those in the control group,CD4^(+)/CD125^(+)was lower than that control group,the differences were statistically significant(P<0.05).After treatment,the physical,emotional,cognitive,role and social scores of both groups were increased,and the physical,emotional,cognitive,role and social scores of the observation group were significantly higher than those of the control group,the differences were statistically significant(P<0.05).There were no sign
作者
沈冰寒
郭伟峰
林洪盛
傅雅雯
黄颂平
SHEN Binghan;GUO Weifeng;LIN Hongsheng;FU Yawen;HUANG Songping(Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China)
出处
《中外医学研究》
2024年第12期1-5,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
泉州市科技计划项目(2022NS060)。
关键词
晚期肺癌
支气管镜下介入冷冻
肿瘤指标
Advanced lung cancer
Interventional freezing under bronchoscopy
Tumor index
