摘要
目的分析程序性死亡受体-1(PD-1)单抗后线辅助治疗晚期结直肠癌患者对胃肠功能、肿瘤标志物的影响。方法前瞻性选取2020年1月至2023年1月海口市人民医院收治的105例晚期结直肠癌患者为研究对象,按照随机数字表法将患者分为对照组(n=50)、研究组(n=55)。对照组采用阿帕替尼治疗,研究组在对照组的基础上联合PD-1单抗后线治疗,3周为1个疗程,共治疗4个疗程。比较两组的临床疗效、胃肠功能改善时间,治疗前、治疗12周后的肿瘤标志物[癌胚抗原、糖类抗原(CA)72-4、CA199]、免疫功能(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))指标以及不良反应发生情况。结果治疗12周后,研究组的客观缓解率(ORR)、病情控制率(DCR)分别为78.33%、90.91%,均高于对照组(58.00%、70.00%),差异均有统计学意义(P<0.05)。研究组患者的首次排便时间、首次排气时间、肠鸣音消退时间分别为(51.50±5.02)、(35.52±4.25)、(44.28±4.80)d,均短于对照组[(69.37±6.40)、(50.63±5.10)、(53.50±6.15)d],差异均有统计学意义(P<0.05)。治疗12周后,研究组癌胚抗原、CA72-4、CA199水平分别为(12.57±1.64)ng/mL、(17.60±3.45)U/mL、(58.29±8.70)kU/L,均低于对照组[(17.24±2.50)ng/mL、(27.59±4.67)U/mL、(82.65±12.29)kU/L],差异均有统计学意义(P<0.05)。治疗12周后,研究组CD4^(+)、CD4^(+)/CD8^(+)水平分别为(21.42±3.54)%、0.73±0.30,均低于对照组[(28.39±4.38)%、1.12±0.41],CD8^(+)水平为(30.36±4.52)%,高于对照组[(25.71±3.30)%],差异均有统计学意义(P<0.05)。研究组的不良反应发生率为9.09%,稍低于对照组(16.00%),但两组比较差异无统计学意义(P>0.05)。结论通过PD-1单抗后线辅助治疗可有效改善晚期结直肠癌患者的临床疗效,效果明显,改善胃肠功能,降低肿瘤标志物指标水平,调节机体免疫功能,可为临床干预此病提供参考。
Objective To analyze the effects of programmed death-1(PD-1)monoclonal adjuvant therapy on gastrointestinal function and tumor markers in advanced colorectal cancer patients.Methods A total of 105 patients with advanced colorectal cancer admitted to Haikou People's Hospital from January 2020 to January 2023 were prospectively selected as the study subjects and divided into the control group(n=50)and the study group(n=55)according to the random number table method.The control group was treated with apatinib,while the study group was treated with PD-1 monoclonal antibody on the basis of the control group.Three weeks was one course of treatment,with a total of four courses of treatment.The clinical efficacy,gastrointestinal function improvement time,tumor markers[carcinoembryonic antigen,carbohydrate antigen(CA)72-4,CA199],immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))indicators before and after 12 weeks of treatment,and incidence of adverse reactions were compared between the two groups.Results After 12 weeks of treatment,the objective remission rate(ORR)and disease control rate(DCR)of the study group were 78.33%and 90.91%,respectively,which were higher than those of the control group(58.00%and 70.00%),and the differences were statistically significant(P<0.05).The first defecation time,first exhaust time,and bowel sound resolution time of the study group patients were(51.50±5.02),(35.52±4.25),and(44.28±4.80)days,respectively,which were shorter than those of the control group[(69.37±6.40),(50.63±5.10),and(53.50±6.15)days],and the differences were statistically significant(P<0.05).After 12 weeks of treatment,the levels of carcinoembryonic antigen,CA72-4,and CA199 in the study group were(12.57±1.64)ng/mL,(17.60±3.45)U/mL,and(58.29±8.70)kU/L,respectively,which were lower than those in the control group[(17.24±2.50)ng/mL,(27.59±4.67)U/mL,and(82.65±12.29)kU/L],and the differences were statistically significant(P<0.05).After 12 weeks of treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)in the study group were(21.42±3.54)%and 0.73±0.30,respectively,which were lower than those in the control group[(28.39±4.38)%and 1.12±0.41],and the level of CD8^(+)was(30.36±4.52)%,which was higher than that in the control group[(25.71±3.30)%],and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the study group was 9.09%,which was slightly lower than that in the control group(16.00%),but the difference was not statistically significant(P>0.05).Conclusion Postoperative adjuvant therapy with PD-1 monoclonal antibody can effectively improve the clinical efficacy of patients with advanced colorectal cancer,with significant effects.It improves gastrointestinal function,reduces the levels of tumor markers,regulates immune function in the body,and provides a reference for clinical intervention in this disease.
作者
吴翔
岳春迪
李春芸
WU Xiang;YUE Chun-di;LI Chun-yun(Department of Regulatory Medical,Haikou People's Hospital,Haikou Hainan 570206,China)
出处
《临床和实验医学杂志》
2024年第9期941-945,共5页
Journal of Clinical and Experimental Medicine
基金
海南省卫生计生行业科研项目(编号:19A200044)。
关键词
结直肠肿瘤
晚期结直肠癌
程序性死亡受体-1单抗
胃肠功能
肿瘤标志物
Colorectal neoplasms
Advanced colorectal cancer
Programmed death receptor-1 monoclonal antibody
Gastrointestinal function
Tumor marker
