| 刘 颖,王 蕾,李 丽,尹红英,刘 倩.信迪利单抗联合紫杉醇+顺铂化疗对老年晚期食管鳞癌
患者免疫功能和肿瘤标志物水平的影响[J].,2025,(5):910-917 |
| 信迪利单抗联合紫杉醇+顺铂化疗对老年晚期食管鳞癌
患者免疫功能和肿瘤标志物水平的影响 |
| Effect of Sintilimab Combined with Paclitaxel + cisplatin Chemotherapy on Immune Function and Tumor Marker Levels in Elderly Patients with Advanced Esophageal Squamous Cell Carcinoma |
| 投稿时间：2024-11-02 |
| DOI：10.13241/j.cnki.pmb.2025.05.013 |
| 中文关键词: 信迪利单抗 紫杉醇 顺铂 晚期食管鳞癌 免疫功能 肿瘤标志物 不良反应 |
| 英文关键词: Sintilimab Paclitaxel Cisplatin chemotherapy Advanced esophageal squamous cell carcinoma Immunity Tumor markers Adverse reactions |
| 基金项目:江苏省卫生科研课题（BJ22010） |
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| 中文摘要: |
| 摘要 目的：分析信迪利单抗联合紫杉醇+顺铂化疗对老年晚期食管鳞癌患者免疫功能和肿瘤标志物水平的影响。方法：将2022年10月至2024年5月88例老年晚期食管鳞癌患者分为信迪利单抗组与化疗组，各44例。化疗组单纯采取紫杉醇+顺铂化疗，信迪利单抗组采取信迪利单抗联合紫杉醇+顺铂化疗。两组均连续治疗3个疗程后比较其临床疗效，治疗前后免疫功能及肿瘤标志物水平变化，并比较其不良反应发生率。结果：信迪利单抗组与化疗组疗效对比发现，信迪利单抗组客观缓解率、疾病控制率均高于化疗组（P<0.05）；治疗后，信迪利单抗组、化疗组CD3+、CD4+、CD4+/CD8+、IgM、IgA均高于治疗前，信迪利单抗组高于化疗组（P<0.05）；分别对比治疗前后肿瘤标志物发现，治疗前，信迪利单抗组、化疗组鳞状细胞癌抗原（SCCA）、糖类抗原724（CA724）、糖类抗原199（CA199）、癌胚抗原（CEA）、细胞角蛋白19片段抗原21-1（CYFRA21-1）比较无明显差异（P>0.05），治疗后，信迪利单抗组、化疗组SCCA、CA724、CA199、CEA、CYFRA21-1均低于治疗前，信迪利单抗组低于化疗组（P<0.05）；通过对比化疗期间不良反应发现，信迪利单抗组、化疗组Ⅰ~Ⅱ级、Ⅲ~Ⅳ级、不良反应总发生率比较无差异（P>0.05）。结论：信迪利单抗联合紫杉醇+顺铂化疗可提升老年晚期食管鳞癌患者客观缓解率、疾病控制率，效果显著，同时可改善患者免疫功能，降低相关肿瘤标志物水平，且不良反应可控。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the effect of Sintilimab combined with paclitaxel + cisplatin chemotherapy on immune function and tumor marker levels in elderly patients with advanced esophageal squamous cell carcinoma. Methods: 88 elderly patients with advanced esophageal squamous cell carcinoma from October 2022 to May 2024 were divided into a Xindilimab group and a chemotherapy group, with 44 cases in each group. The chemotherapy group received only paclitaxel and cisplatin chemotherapy based chemotherapy, while the Sintilimab group received xindilimab combined with paclitaxel and platinum based chemotherapy. Compare the clinical efficacy, changes in immune function and tumor marker levels before and after treatment for three consecutive courses in both groups, and compare the incidence of adverse reactions. Results: Comparison of the efficacy between the Sintilimab group and the chemotherapy group showed that the objective remission rate and disease control rate of the Sintilimab group were higher than those of the chemotherapy group (P<0.05); After treatment, the levels of CD3+, CD4+, CD4+/CD8+, IgM, and IgA in the Sintilimab group and chemotherapy group were higher than before treatment, and the Xindilimab group was higher than the chemotherapy group (P<0.05); Comparing tumor markers before and after treatment, it was found that before treatment, there was no significant differencein squamous cell carcinoma antigen (SCCA), carbohydrate antigen 724 (CA724), carbohydrate antigen 199 (CA199), carcinoembryonic antigen (CEA), and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) between the Sintilimab group and the chemotherapy group (P>0.05). After treatment, there was no significant difference in SCCA, CA724, CA199, CEA, CYFRA21-1 between the Sintilimab group and the chemotherapy group (P>0.05). FRA21-1 levels were lower than before treatment, and the levels in the Sintilimab group were lower than those in the chemotherapy group (P<0.05); By comparing the adverse reactions during chemotherapy, it was found that there was no differencein the incidence of grade I-II, III-IV, and overall adverse reactions between the Sintilimab group and the chemotherapy group (P>0.05). Conclusion: The combination of Sintilimab and paclitaxel+cisplatin chemotherapy can significantly improve the objective remission rate and disease control rate of elderly patients with advanced esophageal squamous cell carcinoma. At the same time, it can improve the patient's immune function, reduce the level of related tumor markers, and have controllable adverse reactions. |
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