PD-1抑制剂Pembrolizumab联合培美曲塞和卡铂对NSCLC患者T淋巴细胞亚群及血清肿瘤标志物的影响

摘要 目的：探讨PD-1抑制剂Pembrolizumab联合培美曲塞和卡铂对非小细胞肺癌（NSCLC）患者T淋巴细胞亚群及血清肿瘤标志物的影响。方法：将苏州大学附属第一医院2018年1月到2020年1月期间收治的80例NSCLC患者根据随机数字表法分为对照组（40例，培美曲塞和卡铂治疗）和观察组（40例，对照组基础上联合PD-1抑制剂Pembrolizumab治疗）。对比两组疗效、T淋巴细胞亚群、血清肿瘤标志物、生存质量及不良反应。结果：观察组的客观有效率、疾病控制率均高于对照组（P<0.05）。与对照组治疗后相比，观察组Karnofsky功能状态（KPS）评分更高（P<0.05）。与对照组治疗后相比，观察组CD3⁺、CD4⁺、CD4⁺/CD8⁺更高，CD8⁺更低（P<0.05）。与对照组治疗后相比，观察组癌胚抗原（CEA）、糖类抗原125（CA125）及细胞角质素片段抗原21-1（CYFRA 21-1）更低（P<0.05）。两组不良反应发生率比较未见差异（P>0.05）。结论：NSCLC患者在化疗基础上联合PD-1抑制剂Pembrolizumab治疗，可提高其治疗效果及生存质量，减轻免疫抑制，阻止肿瘤进展，且安全性较好。

Effects of PD-1 Inhibitors Pembrolizumab Combined with Pemetrexed and Carboplatin on T Lymphocyte Subsets and Serum Tumor Markers in Patients with NSCLC

ABSTRACT Objective: To investigate the effects of PD-1 inhibitors pembrolizumab combined with pemetrexed and carboplatin on T lymphocyte subsets and serum tumor markers in patients with non-small cell lung cancer (NSCLC). Methods: 80 patients with NSCLC in the first affiliated hospital of Suzhou university from January 2018 to January 2020 were randomly divided into control group (40 cases, pemetrexed and carboplatin treatment) and observation group (40 cases, combined with Pembrolizumab treatment). The curative effect, T lymphocyte subsets, serum tumor markers, quality of life and adverse reactions were compared between the two groups. Results: The objective effective rate, disease control rate of the observation group were higher than the control group (P<0.05). Compared with the control group after treatment, the Karnofsky functional status (KPS) score of the observation group was higher (P<0.05). Compared with the control group after treatment, CD3⁺, CD4⁺, CD4⁺/CD8⁺ were higher and CD8⁺ was lower in the observation group (P<0.05). Compared with the control group after treatment, carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and cytokeratin fragment antigen 21-1 (CYFRA 21-1) were lower in the observation group after treatment. There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: PD-1 inhibitor pembrolizumab combined with pemetrexed and carboplatin in the treatment of NSCLC patients, can improve the therapeutic effect and quality of life, reduce immunosuppression, prevent tumor progression and the security is good.