信迪利单抗联合白蛋白结合型紫杉醇、奈达铂一线治疗食管癌的临床研究

Sintilimab combined with albumin-bound paclitaxel and nedaplatin as first-line treatment for esophageal cancer

摘要:

目的 探讨信迪利单抗联合白蛋白结合型紫杉醇、奈达铂一线治疗食管癌的临床疗效、安全性及免疫学指标变化。方法 选取2020年5月—2023年12月徐州市第一人民医院收治的100例食管癌患者，随机分为观察组和对照组，各50例。对照组采用白蛋白结合型紫杉醇与奈达铂治疗，观察组对照组基础上加用信迪利单抗治疗。于治疗前后对两组患者进行疗效评估，并检测肿瘤标志物［细胞角蛋白19片段抗原21-1（CYFRA21-1）、鳞状细胞癌抗原（SCC-Ag）、癌胚抗原（CEA）］、免疫功能指标（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）、血清程序性死亡受体1（PD-1）、程序性死亡配体1（PD-L1）水平及不良反应发生情况。结果 观察组疾病控制率更高（P <0.05）。观察组治疗前后血清CEA、CYFRA21-1、SCC-Ag、CD3⁺、CD4⁺、CD4⁺/CD8⁺、PD-1、PD-L1的差值均大于对照组（P <0.05）。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 信迪利单抗联合白蛋白结合型紫杉醇、奈达铂对食管癌具有较好的疗效，能够改善免疫功能，降低肿瘤标志物水平，且不良反应可耐受，值得在临床上推广应用。

Abstract:

Objective To investigate the clinical efficacy, safety, and changes in immunological indicators of sintilimab combined with albumin-bound paclitaxel and nedaplatin as first-line treatment for esophageal cancer.Methods A total of 100 patients with esophageal cancer admitted to Xuzhou First People's Hospital from May 2020 to December 2023 were selected and randomly divided into an observation group and a control group, with 50 cases in each group. The control group received treatment with albumin-bound paclitaxel and nedaplatin, while the observation group was treated with sintilimab combined with albumin-bound paclitaxel and nedaplatin. Before and after treatment, the therapeutic efficacy was assessed in two groups of patients. The tumor markers [cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA)], immune function indicators, and serum levels of programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) were measured, and adverse reactions were documented.Results The disease control rate was higher in the observation group (P < 0.05). The differences in serum levels of CEA, CYFRA21-1, SCC-Ag, CD3⁺, CD4⁺, CD4⁺/CD8⁺, PD-1, and PD-L1 before and after treatment were greater in the observation group than in the control group (P < 0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusion Sintilimab combined with albumin-bound paclitaxel and nedaplatin demonstrates favorable efficacy in esophageal cancer, improves immune function, reduces tumor marker levels, and is associated with tolerable adverse effects, suggesting its potential for clinical application.