卡瑞利珠单抗联合化疗方案对中晚期食管癌患者血清miR-21、可溶性E-钙黏蛋白表达的影响

目的 探讨卡瑞利珠单抗联合化疗方案对中晚期食管癌患者血清miR-21、可溶性E-钙黏蛋白（sE-Cad）表达的影响。方法 中晚期食管癌患者110例按用药方案不同分为联合组（57例）和化疗组（53例）。化疗组患者接受紫杉醇（260 mg/m²）+顺铂（30 mg/m²）方案治疗,联合组在此基础上接受卡瑞利珠单抗（200 mg/次,1次/2周）治疗。治疗4~6个周期后,评估2组总体疗效;酶联免疫吸附试验法检测血清肿瘤标志物、sE-Cad水平,实时荧光定量聚合酶链反应检测血清miR-21水平;记录治疗期间不良反应发生情况。结果 治疗后,联合组患者的客观有效率（ORR）为70.18%,疾病控制率（DCR）为91.23%,高于化疗组的45.28%和77.36%（P<0.05）;治疗后联合组血清糖类抗原125（CA125）、癌胚抗原（CEA）、鳞状细胞癌相关性抗原（SCC）、miR-21和sE-Cad水平均明显低于化疗组（P<0.05）;治疗期间,联合组的反应性毛细血管增生症发生率高于化疗组（P<0.01）。结论 卡瑞利珠单抗联合化疗方案治疗中晚期食管癌近期疗效良好,可有效降低肿瘤标志物水平,下调miR-21、sE-Cad在血清中的表达。

Effects of camrelizumab combined with chemotherapy on serum miR-21 and soluble E-cadherin in patients with advanced esophageal cancer

Objective To investigate the effect of camrelizumab combined with chemotherapy on serum miR-21 and soluble E-cadherin (sE-Cad) in patients with advanced esophageal cancer. Methods A total of 110 patients with advanced esophageal cancer were divided into the combination group (57 cases) and the chemotherapy group (53 cases) according to different therapeutic regimens. Patients in the chemotherapy group were treated with paclitaxel (260 mg/m²) and cisplatin (30 mg/m²) for chemotherapy, while those in the combination group were additionally treated with camrelizumab (200 mg every time, once every 2 weeks) on this basis. The overall curative effect was evaluated after 4-6 cycles of treatment. The serum levels of tumor markers and sE-Cad were detected by enzyme linked immunosorbent assay, and the serum level of miR-21 was detected by real-time fluorescence quantitative polymerase chain reaction. The incidence of adverse reactions during treatment was recorded. Results After treatment, the objective response rate (ORR) and disease control rate (DCR) were higher in the combination group than those in the chemotherapy group (70.18% vs. 45.28% and 91.23% vs. 77.36%, P<0.05). The serum levels of carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), squamous cell carcinoma-related antigens (SCC), miR-21 and sE-Cad were significantly lower in the combination group than those in the chemotherapy group (P<0.05). During treatment, the incidence of reactive capillary endothelial proliferation was higher in the combination group than that of the chemotherapy group (P<0.01). Conclusion Camrelizumab combined with chemotherapy has good short-term efficacy in the treatment of advanced esophageal cancer, which can effectively reduce levels of tumor markers, down-regulate serum miR-21 and sE-Cad.