摘要
目的分析程序性死亡蛋白-1(programmed death protein-1,PD-1)抑制剂对老年Ⅲa期非小细胞肺癌(non-small cell lung carcinoma,NSCLC)患者胸腔镜下肺癌根治术后临床预后的影响。方法选取2019年1月至2021年1月吉林大学第一医院收治的150例老年Ⅲa期NSCLC患者为研究对象,使用随机数字表法将入选患者分别纳入研究组和对照组,每组各75例,均行胸腔镜下肿瘤切除术和淋巴结清扫治疗,对照组患者术后行化疗治疗,研究组患者在对照组基础上接受PD-1抑制剂治疗。对比两组患者治疗效果、血清学指标变化、术后6个月生存情况。结果术后12周,研究组患者治疗总有效率显著高于对照组(P<0.05),两组患者各类不良反应发生率比较差异均无统计学意义(均P>0.05)。术后12周,两组患者胰岛素样生长因子1受体(insulin-like growth factor 1 receptor,IGF-1R)水平均显著低于本组术前(均P<0.05),人S100钙结合蛋白A2(human S100 calcium-binding protein A2,S100A2)水平均显著高于本组术前(均P<0.05);研究组患者术后12周血清IGF-1R水平显著低于对照组(P<0.05),S100A2水平显著高于对照组(P<0.05)。术后6个月,两组患者总生存率比较差异无统计学意义(P>0.05),研究组患者无进展生存率显著高于对照组(P<0.05)。结论对于老年Ⅲa期NSCLC患者而言,术后在化疗的基础上给予PD-1抑制剂能够在保证治疗安全性的前提下进一步提高临床疗效、改善血清学指标,并提高患者近期无进展生存率。
Objective To analyze the effects of programmed death protein-1(PD-1)inhibitor on the clinical prognosis of elderly patients with stageⅢa non-small cell lung carcinoma(NSCLC)after thoracoscopic radical lung cancer surgery.Method A total of 150 elderly patients with stageⅢa NSCLC admitted to the First Hospital of Jilin University from January 2019 to January 2021 were randomly divided into study group and control group,with 75 cases in each group.All patients received thoracoscopic tumor resection and lymph node dissection.Control group patients received postoperative chemotherapy,and study group patients received PD-1 inhibitor treatment on the basis of control group.The therapeutic effect,the changes of serological indexes and the survival of the two groups at 6 months after operation were compared.Result Twelve weeks after operation,the total effective rate of patients in study group was significantly higher than that in control group(P<0.05),and there was no significant difference in the incidence of various adverse reactions between the two groups(all P>0.05).Twelve weeks after operation,the levels of insulin-like growth factor 1 receptor(IGF-1R)in the two groups were significantly lower than those before operation in the same group(all P<0.05),and the levels of human S100 calcium-binding protein A2(S100A2)were significantly higher than those before operation in the same group(all P<0.05).The serum IGF-1R level of patients in study group at 12 weeks after operation was significantly lower than that in control group(P<0.05),and the level of S100A2 was significantly higher than that in control group(P<0.05).Six months after operation,there was no significant difference in the overall survival rate between the two groups(P>0.05),the progress free survival rate of patients in study group was significantly higher than that in control group(P<0.05).Conclusion For the elderly patients with stageⅢa NSCLC,the PD-1 inhibitor on the basis of postoperative chemotherapy can further improve the clinical efficacy,serum indexes and short-term progress free survival rate of patients on the premise of ensuring the safety of treatment.
作者
都盼盼
栾颖
张广娟
Du Panpan;Luan Ying;Zhang Guangjuan(Department of No.2 Thoracic Surgery,the First Hospital of Jilin University,Jilin 130031,China)
出处
《中国医学前沿杂志（电子版）》
2021年第12期143-147,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
程序性死亡蛋白-1
胸腔镜
非小细胞肺癌
预后
Programmed death protein-1
Thoracoscope
Non-small cell lung carcinoma
Prognosis
