2023 年第 12 期 第 18 卷

白蛋白结合型紫杉醇联合铂类化疗方案及调强放疗对进展期食管癌患者免疫功能和血清肿瘤标志物的影响

Effects of albumin-bound paclitaxel combined with platinum-based chemotherapy and intensity-modulated radiotherapy on immune function and serum tumor markers in patients with advanced esophageal cancer

作者：方圆孟玮刘兰黎鹏石静

英文作者：Fang Yuan Meng Wei Liu Lan Li Peng Shi Jing

单位：河北北方学院附属第一医院肿瘤内科，张家口075000

英文单位：Department of Medical Oncology， the First Affiliated Hospital of Hebei North University Zhangjiakou 075000 China

关键词：食管癌；白蛋白结合型紫杉醇；调强放疗；肿瘤标志物

英文关键词：Esophagealcancer;Albumin-boundpaclitaxel;Intensity-modulatedradiotherapy;Tumormarkers

• 摘要：

• 目的  探讨白蛋白结合型紫杉醇联合铂类化疗及调强放疗对进展期食管癌患者免疫功能和肿瘤标志物的影响。方法  选取2020年3月至2021年12月于河北北方学院附属第一医院治疗的62例进展期食管癌患者作为研究对象。根据简单随机数字表法将患者分为观察组（31例）和对照组（31例）。对照组采取含铂化疗联合调强放疗方案，观察组在对照组基础上加用白蛋白结合型紫杉醇。比较2组治疗前后血清癌胚抗原、细胞角蛋白19片段（CYFRA21-1）、鳞状细胞癌抗原（SCC-Ag）水平及T细胞分布情况。记录患者Karnofsky功能状态（KPS）评分、骨髓抑制程度及疗效。结果  治疗后，2组血清癌胚抗原、CYFRA21-1、SCC-Ag水平均低于治疗前，且观察组均低于对照组［（1.6±0.4）mg/L比（2.1±0.4）mg/L、（2.2±0.5）μg/L比（2.7±0.6）μg/L、（0.79±0.25）μg/L比（0.94±0.27）μg/L］；观察组CD+3、CD+4和CD+4/CD+8比值均低于治疗前且低于对照组，CD+8高于治疗前且高于对照组（均P＜0.05）。治疗后，观察组KPS评分明显高于对照组（P＜0.001）。观察组骨髓抑制评分低于对照组，肿瘤控制率高于对照组（均P＜0.05）。结论  白蛋白结合型紫杉醇联合铂类化疗及调强放疗对进展期食管癌患者肿瘤控制疗效较好，可显著降低肿瘤标志物水平，提高患者免疫功能，改善患者生活质量，并减轻放化疗带来的毒副作用。

• Objective To investigate the effects of albumin-bound paclitaxel combined with platinum-based chemotherapy and intensity-modulated radiotherapy on immune function and tumor markers in patients with advanced esophageal cancer. Methods Totally 62 patients with advanced esophageal cancer admitted to the First Affiliated Hospital of Hebei North University from March 2020 to December 2021 were enrolled. According to the simple random number table method, patients were divided into observation group (31 cases) and control group (31 cases). The control group received platinum-based chemotherapy combined with intensity-modulated radiotherapy, and the observation group received albumin-bound paclitaxel on the basis of the control group. Serum levels of carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), squamous cell cancer-antigen (SCC-Ag), and the distribution of T lymphocytes before and after treatment in the two groups were compared. Karnofsky performance status (KPS) score, degree of myelosuppression and curative rate of patients were recorded. Results  After treatment, serum levels of CEA, CYFRA21-1 and SCC-Ag in both groups were lower than those before treatment, and the observation group was lower than the control group［（1.6±0.4）mg/L vs （2.1±0.4）mg/L,（2.2±0.5）μg/L vs （2.7±0.6）μg/L,（0.79±0.25）μg/L vs （0.94±0.27）μg/L］; CD+3, CD+4 and CD+4/CD+8 ratio in the observation group after treatment were lower than those before treatment and the control group, and CD+8 was higher than that before treatment and the control group (all P<0.05). After treatment, KPS score in the observation group was significantly higher than that in the control group (P<0.001). The myelosuppression score in the observation group was lower than that in the control group, and the tumor control rate in the observation group was higher than that in the control group (both P<0.05). Conclusions  Albumin-bound paclitaxel combined with platinum-based chemotherapy and intensity-modulated radiotherapy have good effect on tumor control in patients with advanced esophageal cancer, which can significantly reduce the level of tumor markers, improve the immune function of patients, improve the quality of life of patients, and reduce the toxicity caused by radiotherapy and chemotherapy.