Clinical observation of sindillimab combined with gemcitabine in treatment of stage Ⅳ patients with squamous cell lung carcinoma
Objective To analyze the effects of sindellizumab combined with gemcitabine on the content of vascular endothe-lial cell growth factor and immune molecules in patients with stage Ⅳ squamous cell lung carcinoma.Methods Eighty-three patients with stage Ⅳ squamous cell lung carcinoma in Jiyuan Peoples Hospital from 2020-09-05 to 2021-08-10 were selected as the study objects,and grouped them according to the balance principle of gender,age,course of disease and smoking history.Forty-one patients in the control group were treated with gemcitabine combined with cisplatin,and 42 patients in the study group were treated with gemcitabine combined with sindellizumab.After 16 weeks,the clinical effi-cacy of the two groups was compared.After 6 weeks,the levels of tumor markers and vascular endothelial growth factor were detected by enzyme-linked immunosorbent assay.After 6 weeks,the cellular immunity level was detected by flow cytometry.Adverse reactions during treatment were recorded.The study data were collected by clinical registration data,examination and test,questionnaire survey.Univariate covariance test and repeated measurement analysis of variance were conducted.Results The total effective rate of the study group was 71.43％higher than that of the control group 48.78％,with statistical significance(x2=4.443,P=0.035).After treatment,the CEA level in the study group(19.72 ±2.34)ng/mL was lower than that in the control group(29.36±3.69)ng/mL,and the difference was statistically significant,F=14.875,P＜0.001;The level of cytokeratin fragment 19 antigen 21-1(CYFRA21-1)was(9.87±1.04)ng/mL lower than that of control group(14.07±1.62)ng/mL,the difference was statistically significant,F=14.793,P＜0.001;Squamous cell carcinoma antigen(SCCA)level(3.65±0.47)ng/mL was lower than that of control group(5.58±0.68)ng/mL,the difference was statistically significant(F=15.854,P＜0.001).After treatment,the vascular endothelial growth factor(VEGF)level in the study group(125.13±16.84)pg/mL was lower than that in the control group(173.67±20.08)pg/mL,the difference was statistically significant,F=12.059,P＜0.001;The level of transforming growth factor-β(TGF-β)pg/mL(67.09±8.18)was lower than that of control group(97.18±9.36)pg/mL,the difference was statistically significant,F=15.178,P＜0.001;The neuron-specific enolase(NSE)level(14.81±2.03)ng/mL was lower than that of the control group(20.62±5.73)pg/mL,and the difference was statistically significant(F=6.836,P＜0.001).After treatment,the level of CD3+in the study group(64.98±6.34)％was higher than that in the control group(62.05±6.19)％,the difference was sta-tistically significant,F=2.853,P=0.032;CD4+level(42.18±5.40)％was higher than that of control group(37.59± 5.38)％,the difference was statistically significant,F=3.905,P＜0.001;CD8+level(23.39±3.76)％was higher than con-trol group(21.06±3.69)％,the difference was statistically significant,F=2.972,P=0.006.There was no significant differ-ence in the incidence of nausea,vomiting,diarrhea,bone marrow suppression,rash and liver and kidney function injury between 2 groups(P＞0.05).Conclusions Sindillimab combined with gemcitabine has a definite effect in the treatment of patients with advanced lung squamous cell carcinoma,which can effectively inhibit the spread of tumor cells,reduce the level of tumor markers and vascular endothelial growth factor,regulate immune function without increasing adverse reactions,and is worthy of clinical promotion and application.
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