迪利单抗对肺癌患者嗜酸性气道炎症的研究

目的 探讨信迪利单抗对肺癌患者嗜酸性气道炎症的影响。方法 选取2019年4月—2020年4月于徐州医科大学附属宿迁医院就诊的60例IV期非鳞非小细胞肺癌患者,随机分为对照组(单纯化疗组)和试验组(信迪利单抗联合化疗组);对照组给予培美曲塞500 mg/m2联合顺铂75 mg/m2静脉注射;试验组在对照组治疗方案基础上联合免疫检查点抑制剂信迪利单抗200 mg静脉注射,均21天为1个周期。6个周期治疗后检测两组患者呼出气一氧化氮(Fractional exhaled nitric oxide,FeNO)、外周血嗜酸性粒细胞计数、肺功能及动脉血气;分析信迪利单抗治疗组严重不良事件(SAE)及免疫相关性肺炎(CIP)的发生率。结果 ⑴试验组在第2、4、6周期治疗后FeNO水平、外周血嗜酸性粒细胞计数相较于基线水平出现升高趋势,但差异无统计学意义(PFeNO=0.536; PEos=0.762)。⑵两组患者经6个周期治疗后,第1秒用力呼吸容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、一氧化碳弥散量占预计值百分比(DLco%)较治疗前均无明显变化(PFEV1=0.615; PFVC=0.473; PFEV1/FVC=0.637; PDLco%=0.598);动脉血气分析中PH、PaO2、PaCO2水平较治疗前均无明显变化(PPH=0.457; PPaCO2=0.242; PPaO2=0.631)。⑶试验组免疫相关SAE发生率和CIP的发生率均为0。结论 6周期治疗后信迪利单抗对肺癌患者的嗜酸性气道炎症、肺功能、动脉血气分析无明显影响,未出现免疫相关SAE及CIP。

Effect of sintilimab on eosinophilic airway inflammation in patients with lung cancer

Objective To investigate the effect of sintilimab on eosinophilic airway inflammation in patients with non-squamous non-small cell lung cancer (NSCLC). Methods A total of 60 patients with stage IV non-squamous NSCLC in the Suqian Hospital Affiliated to Xuzhou Medical University from April 2019 to April 2020 were selected, and they were randomly divided into a control group (chemotherapy alone group) and a trial group (sintilimab combined with chemotherapy group). The patients in the control group were given pemetrexed 500mg/m2 combined with cisplatin 75 mg/m2 intravenously for 21 days as a cycle, and the patients in trial group were given the same chemotherapy combined with the immune checkpoint inhibitor sintilimab 200 mg intravenously for 21 days as a cycle. After 6 cycles of the treatment, the fractional exhaled nitric oxide (FeNO), peripheral blood eosinophil count, pulmonary function and arterial blood gas were measured. The incidence of serious adverse events (SAE) and immune associated pneumonia (CIP) in the trial group were analyzed. Results ⑴ The FeNO level and peripheral blood eosinophil count increased in the trial group compared with the baseline level after the 2nd, 4th and 6th cycles of the treatment, but the difference was not statistically significant (PFeNO=0.536; PEos=0.762). ⑵ The forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC and diffusing capacity of the lung for carbon monoxide levels (DLco %) in the lung function of the two groups had no change after 6 cycles of the treatment (PFEV1=0.615; PFVC=0.473; PFEV1/FVC=0.637; PDLco%=0.598). The PH, PaO2 and PaCO2 levels in the arterial blood gas analysis of the two groups had no change after 6 cycles of the treatment (PPH=0.457; PPaCO2=0.242; PPaO2=0.631). ⑶ The incidence rates of immune-related SAE and CIP in the trial group were both 0. Conclusion Sintilimab has no significant effect on eosinophilic airway inflammation in the patients with stage IV non-squamous NSCLC. There is no significant influence on pulmonary ventilation function and arterial blood gas analysis, and there is no immune related SAE and CIP.