卡瑞利珠单抗联合化疗对晚期非鳞非小细胞肺癌患者免疫功能和NLR、CAR的影响

摘要 目的：探讨卡瑞利珠单抗联合化疗对晚期非鳞非小细胞肺癌（NSCLC）患者免疫功能和中性粒细胞与淋巴细胞比值（NLR）、C-反应蛋白与白蛋白比值（CAR）的影响。方法：采用回顾性分析，选取2020年1月到2022年12月期间安徽医科大学第一附属医院北区收治的晚期非鳞NSCLC患者100例，按照治疗方法将患者分为对照组（n=48）和观察组（n=52）。对照组接受注射用培美曲塞二钠联合顺铂注射液或注射用奈达铂化疗，观察组在对照组基础上接受卡瑞利珠单抗治疗。对比两组疗效、免疫功能、肿瘤标志物、NLR、CAR，同时观察两组治疗期间不良反应发生率。结果：与对照组相比，观察组的临床总有效率更高（P<0.05）。治疗4个周期后，与对照组相比，观察组癌胚抗原（CEA）、细胞角蛋白19片段抗原21-1（CYFRA21-1）、糖类抗原125（CA125）、NLR、CAR、CD8⁺更低，CD3⁺、CD4⁺、CD4⁺/CD8⁺更高（P<0.05）。两组不良反应发生率对比未见差异（P>0.05）。结论：晚期非鳞NSCLC患者在化疗的基础上结合卡瑞利珠单抗治疗，有助于控制疾病进展，提高临床疗效，降低肿瘤标志物水平，提高免疫功能，降低NLR、CAR。

Effect of Camrelizumab Combined with Chemotherapy on Immune Function,NLR, CAR in Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer

ABSTRACT Objective: To investigate the effect of Camrelizumab combine with chemotherapy on immune function, neutrophil to lymphocyte ratio (NLR), C-reactive protein to albumin ratio (CAR) in patients with advanced non-squamous non-small cell lung cancer (NSCLC). Methods: Used retrospective analysis, 100 patients with advanced non-squamous NSCLC who were admitted to the first affiliated hospital of Anhui medical university north district from January 2020 to December 2022 were selected, and patients were divided into control group (n=48) and observation group (n=52) according to the treatment methods. Control group received chemotherapy with pemetrexed disodium combined with cisplatin injection or nedaplatin for injection, and observation group received Camrelizumab treatment on the basis of control group. The efficacy, immune function, tumor markers, NLR, and CAR were compared between two groups, and the incidence of adverse reactions during treatment were observed simultaneously in two groups. Results: Compared with control group, the clinical total effective rate in observation group was higher (P<0.05). 4 cycles after treatment, compared with control group, the carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carbohydrate antigen 125 (CA125), NLR, CAR and CD8⁺ in observation group were lower, while CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were higher (P<0.05). There was no difference in the incidence of adverse reactions between two groups (P>0.05). Conclusion: Patients with advanced non-squamous NSCLC combine with Camrelizumab treatment on the basis of chemotherapy, which is helpful to control disease progression, improve clinical efficacy, reduce tumor markers levels, improve immune function, and reduce NLR and CAR.