| 王雪委,黄于庭,刘 克,施险峰,肖 鑫.卡瑞利珠单抗联合标准二线化疗对晚期食管鳞癌患者肿瘤标志物和外周血NLR、LMR的影响及其预后的影响因素分析[J].,2023,(12):2315-2319 |
| 卡瑞利珠单抗联合标准二线化疗对晚期食管鳞癌患者肿瘤标志物和外周血NLR、LMR的影响及其预后的影响因素分析 |
| Effect of Camrelizumab Combined with Standard Second-Line Chemotherapy on Tumor Markers and Peripheral Blood NLR and LMR in Patients with Advanced Esophageal Squamous Cell Carcinoma and the Analysis of its Prognostic Factors |
| 投稿时间：2023-03-03 修订日期：2023-03-27 |
| DOI：10.13241/j.cnki.pmb.2023.12.021 |
| 中文关键词: 晚期食管鳞癌 卡瑞利珠单抗 化疗 肿瘤标志物 NLR LMR 预后 |
| 英文关键词: Advanced esophageal squamous cell carcinoma Camrelizumab Chemotherapy Tumor markers NLR LMR Prognosis |
| 基金项目:安徽省高校自然科学重点项目（2022AH050791）；安徽医科大学校科研基金项目（2022xkj206） |
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| 中文摘要: |
| 摘要 目的：探讨卡瑞利珠单抗联合标准二线化疗对晚期食管鳞癌患者肿瘤标志物和外周血中性粒细胞/淋巴细胞比值（NLR）、淋巴细胞/单核细胞比值（LMR）的影响，并分析影响晚期食管鳞癌预后的因素。方法：选择2019年8月至2021年8月安徽医科大学附属巢湖医院收治的80例晚期食管鳞癌患者，根据治疗方法将其分为对照组（40例）采用标准二线化疗治疗，观察组（40例）采用卡瑞利珠单抗联合标准二线化疗治疗。比较两组疗效、血清肿瘤标志物以及外周血NLR、LMR水平以及安全性差异。绘制Kaplan-Meier曲线，分析不同治疗方案晚期食管鳞癌患者总生存期（OS）期差异，多因素Cox回归分析影响晚期食管鳞癌患者预后的因素。结果：观察组客观缓解率（ORR）、疾病控制率（DCR）高于对照组（P＜0.05）；两组治疗后血清糖类抗原125（CA125）、糖类抗原199（CA199）、癌胚抗原（CEA）、糖类抗原724（CA724）以及外周血NLR水平均较治疗前降低（P＜0.05），外周血LMR较治疗前增高（P＜0.05），观察组治疗后血清CA125、CA199、CEA、CA724水平以及外周血NLR低于对照组（P＜0.05），外周血LMR水平高于对照组（P＜0.05）；两组不良反应发生率比较无差异（P＞0.05）。观察组中位无进展生存期（PFS）、OS生存期长于对照组（P＜0.05）。多因素Cox回归分析结果显示TNM分期Ⅳ期、远处转移、高NLR是影响晚期食管鳞癌患者预后的危险因素（P＜0.05），高LMR、卡瑞利珠单抗联合标准二线化疗是保护因素（P＜0.05）。结论：卡瑞利珠单抗联合标准二线化疗可提高晚期食管磷癌临床疗效，降低血清肿瘤标志物以及外周血NLR水平，提高外周血LMR水平，TNM分期Ⅳ期、远处转移、高NLR是影响晚期食管鳞癌患者预后的危险因素，高LMR、卡瑞利珠单抗联合标准二线化疗是其保护因素。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of camrelizumab combined with standard second-line chemotherapy on tumor markers, peripheral blood neutrophil/lymphocyte ratio (NLR) and lymphocyte/monocyte ratio (LMR) in patients with advanced esophageal squamous cell carcinoma, and to analyze the factors affecting the prognosis of advanced esophageal squamous cell carcinoma. Methods: 80 patients with advanced esophageal squamous cell carcinoma who were admitted to Chaohu Hospital affiliated to Anhui Medical University from August 2019 to August 2021 were selected. According to treatment methods, the patients were divided into control group (40 cases) receiving standard second-line chemotherapy, and observation group (40 cases) receiving camrelizumab combined with standard second-line chemotherapy. The efficacy, the levels of serum tumor markers, peripheral blood NLR, LMR and safety were compared in the two groups. Kaplan-Meier curve was drawn to analyze the differences in overall survival (OS) of patients with advanced esophageal squamous cell carcinoma under different treatment regimens, and the factors affecting the prognosis of patients with advanced esophageal squamous cell carcinoma were analyzed by multivariate Cox regression. Results: The objective remission rate (ORR) and disease control rate (DCR) in the observation group were higher than those in the control group (P＜0.05). The levels of serum carbohydrate antigen 125 (CA125),carbohydrate antigen 199(CA199), carcinoembryonic antigen (CEA), carbohydrate antigen 724 (CA724) and peripheral blood NLR in the two groups after treatment were lower than those before treatment (P＜0.05), and the level of peripheral blood LMR was higher than that before treatment (P＜0.05). The levels of serum CA125, CA199, CEA, CA724 and peripheral blood NLR in the observation group after treatment were lower than those in the control group (P＜0.05), while the level of peripheral blood LMR was higher than that in the control group (P＜0.05). There was no statistical significance in the incidence rate of adverse reactions in the two groups (P>0.05). The median progression-free survival (PFS) and OS survival in the observation group were longer than those in the control group (P＜0.05). Multivariate Cox regression analysis showed that TNM stage Ⅳ, distant metastasis and high NLR were risk factors for the prognosis of patients with advanced esophageal squamous cell carcinoma (P＜0.05), while high LMR, camrelizumab and standard second-line chemotherapy were protective factors (P＜0.05). Conclusion: Camrelizumab combined with standard second-line chemotherapy can improve the clinical efficacy of advanced esophageal squamous cell carcinoma, reduce the levels of serum tumor markers and peripheral blood NLR, and improve the level of peripheral blood LMR. TNM stage Ⅳ, distant metastasis, and high NLR are risk factors affecting the prognosis of patients with advanced esophageal squamous cell carcinoma, and high LMR, camrelizumab and standard second-line chemotherapy are protective factors. |
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