摘要
目的 探讨微波消融术联合免疫治疗对中晚期非小细胞肺癌的临床疗效.方法 74 例中晚期非小细胞肺癌患者,随机分为免疫非消融组和免疫消融组,各 37 例.免疫非消融组行免疫治疗,免疫消融组应用微波消融术联合免疫治疗.比较两组肿瘤最大直径与肿瘤体积、近期疗效、肿瘤标志物及免疫指标.结果 治疗后 6 个月,免疫消融组肿瘤最大直径(1.58±0.53)cm和肿瘤体积(2.36±0.75)cm3均显著小于免疫非消融组的(2.75±0.79)cm、(5.68±0.79)cm3(P<0.05).免疫消融组近期有效率(72.97%,27/37)显著高于免疫非消融组(48.65%,18/37)(P<0.05);免疫消融组疾病控制率(94.59%,35/37)显著高于免疫非消融组(72.97%,27/37)(P<0.05).免疫消融组治疗后 6 个月癌胚抗原(5.06±1.38)μg/L、细胞角蛋白 19 片段(4.92±1.23)ng/ml和鳞状上皮细胞癌抗原(3.69±1.61)ng/ml显著低于免疫非消融组的(7.91±1.42)μg/L、(6.76±1.69)ng/ml、(4.56±1.68)ng/ml(P<0.05).治疗后 6 个月免疫消融组CD3+、CD4+、CD4+/CD8+水平分别为(64.58±8.23)%、(42.57±5.32)%、(1.86±0.45)显著高于免疫非消融组的(50.15±7.68)%、(34.95±4.63)%、(1.56±0.38)(P<0.05).结论 微波消融术联合替雷利珠单抗免疫治疗中晚期非小细胞肺癌可有效提升治疗效果,促进肿瘤缩小,并可降低肿瘤标志物水平,提升患者免疫力,值得推广.
Abstract
Objective To explore the clinical efficacy of microwave ablation combined with immunotherapy in the treatment of advanced non-small-cell lung carcinoma.Methods A total of 74 patients with advanced non-small-cell lung carcinoma were randomly divided into immune non-ablation group and immune ablation group,with 37 cases in each group.The immune non-ablation group was treated with immunotherapy,and the immune ablation group was treated with microwave ablation on the basis of the immune non-ablation group.The maximum tumor diameter,tumor volume,short-term efficacy,tumor markers and immune indexes were compared between the two groups.Results At 6 months after treatment,the maximum tumor diameter and tumor volume in immune ablation group were(1.58±0.53)cm and(2.36±0.75)cm3,which were significantly smaller than(2.75±0.79)cm and(5.68±0.79)cm3 in immune non-ablation group(P<0.05).The short-term effective rate in immune ablation group(72.97%,27/37)was significantly higher than that in immune non-ablation group(48.65%,18/37)(P<0.05).The disease control rate in immune ablation group(94.59%,35/37)was significantly higher than that in immune non-ablation group(72.97%,27/37)(P<0.05).At 6 months after treatment,the immune ablation group had carcinoembryonic antigen of(5.06±1.38)μg/L,cytokeratin 19 fragment of(4.92±1.23)ng/ml and squamous cell carcinoma antigen of(3.69±1.61)ng/ml,which were significantly lower than(7.91±1.42)μg/L,(6.76±1.69)ng/ml and(4.56±1.68)ng/ml in immune non-ablation group(P<0.05).At 6 months after treatment,the levels of CD3+,CD4+and CD4+/CD8+in immune ablation group were(64.58±8.23)%,(42.57±5.32)%and(1.86±0.45)%,which were significantly higher than(50.15±7.68)%,(34.95±4.63)%and(1.56±0.38)in immune non-ablation group(P<0.05).Conclusion Microwave ablation combined with tislelizumab immunotherapy in the treatment of advanced non-small cell lung cancer can effectively improve the therapeutic effect,accelerate the reduction of tumor size,decrease the level of tumor markers and enhance the immunity of patients,which is worth spreading.
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