帕博利珠单抗联合培美曲塞和卡铂治疗晚期非鳞状非小细胞肺癌的疗效及对肿瘤标志物和细胞免疫功能的影响

摘要 目的：探讨卡铂和培美曲塞联合帕博利珠单抗治疗对晚期非鳞状非小细胞肺癌（NSCLC）细胞免疫功能和肿瘤标志物的影响。方法：选取2018年10月~2021年2月期间徐州医科大学附属医院收治的78例晚期非鳞状NSCLC患者,按照随机数字表法分为对照组（n=39,接受培美曲塞联合卡铂治疗）和联合组（n=39,在对照组的基础上接受帕博利珠单抗治疗）。对比两组疗效、肿瘤标志物水平、细胞免疫功能指标、不良反应发生情况。结果：联合组的客观缓解率、疾病控制率均高于对照组（P<0.05）。两组不良反应发生率对比无差异（P>0.05）。治疗后,两组癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）、糖类抗原125（CA125）水平下降,且联合组低于对照组（P<0.05）。治疗后,两组CD3⁺、CD4⁺、CD4⁺/CD8⁺下降,但联合组高于对照组（P<0.05）;治疗后,两组CD8⁺升高,但联合组低于对照组（P<0.05）。结论：帕博利珠单抗联合培美曲塞和卡铂治疗晚期非鳞状NSCLC,可有效控制疾病进展,改善患者免疫功能,降低CEA、CYFRA21-1、CA125水平。

Efficacy of Pembrolizumab Combined with Pemetrexed and Carboplatin in the Treatment of Advanced Non Squamous Non-small Cell Lung Cancer and Its Effects on Tumor Markers and Cellular Immune Function

ABSTRACT Objective: To explore the efficacy of carboplatin and pemetrexed combined with pablizumab in the treatment of advanced non squamous non-small cell lung cancer (NSCLC) and its effects on cellular immune function and tumor markers. Methods: 78 patients with advanced non squamous NSCLC who were admitted to the Affiliated Hospital of Xuzhou Medical University from October 2018 to February 2021 were selected, they were divide into control group (n=39, received pemetrexed combined with carboplatin treatment) and combined group(n=39, received pembrolizumab treatment on the basis of control group) according to the random number table method. The efficacy, tumor marker levels, cellular immune function indicators, incidence of adverse reactions. Results: The objective response rate and disease control rate of combined group were higher than those of control group(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05). After treatment, the carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), and carbohydrate antigen 125 (CA125) levels decreased of two groups, and combined group were lower than those of control group (P<0.05). After treatment, the CD3⁺, CD4⁺, and CD4⁺/CD8⁺ decreased of two groups, but combined group were higher than those of control group(P<0.05). After treatment, the CD8⁺ increased of two groups, but combined group was lower than that of control group(P<0.05). Conclusion: Pabolizumab combined with pemetrexed and carboplatin in the treatment of advanced non-squamous NSCLC can effectively control disease progression, improve patient immune function, and reduce CEA, CYFRA21-1, and CA125 levels.