目的 探討替雷利珠單抗注射液聯(lián)合XELOX方案治療晚期胃癌的臨床療效。方法 選取2021年1月—2023年1月涇縣醫(yī)院收治的60例晚期胃癌患者，采用隨機(jī)數(shù)字表法將納入患者分為對(duì)照組和治療組，每組30例。對(duì)照組采用XELOX方案：第1天靜脈滴注注射用奧沙利鉑130 mg/m²，同時(shí)口服卡培他濱片1 000 mg/m²，2次/d，連續(xù)治療14 d，并以3周為1個(gè)療程。治療組在對(duì)照組基礎(chǔ)上靜脈滴注替雷利珠單抗注射液200 mg/次，3周用藥1次，3周為1個(gè)療程。兩組患者均連續(xù)治療3個(gè)療程。比較兩組近期臨床療效、免疫功能指標(biāo)和血清腫瘤標(biāo)志物。結(jié)果 治療組的總有效率高于對(duì)照組的總有效率（P＜0.05）。治療后，對(duì)照組CD3⁺T細(xì)胞、CD4⁺T細(xì)胞和CD4⁺T/CD8⁺T比值均顯著降低，治療組CD3⁺T細(xì)胞、CD4⁺T細(xì)胞和CD4⁺T/CD8⁺T比值均顯著升高（P＜0.05）；治療組患者CD3⁺T細(xì)胞、CD4⁺T細(xì)胞和CD4⁺T/CD8⁺T比值均明顯高于對(duì)照組（P＜0.05）。治療后，兩組血清糖類抗原199（CA199）、基質(zhì)金屬蛋白酶-2（MMP-2）、血管內(nèi)皮生長(zhǎng)因子（VEGF）水平均顯著降低（P＜0.05），且治療組血清CA199、MMP-2、VEGF水平均低于對(duì)照組（P＜0.05）。結(jié)論 替雷利珠單抗聯(lián)合XELOX方案可提高晚期胃癌患者的近期療效，促進(jìn)免疫功能恢復(fù)，加強(qiáng)抗腫瘤效果。

Objective To study clinical efficacy of Tislelizumab Injection combined with XELOX regimen in treatment of advanced gastric cancer. Methods Patients (60 cases) with advanced gastric cancer in Jingxian Hospital from January 2021 to January 2023 were divided into control (30 cases) and treatment groups (30 cases) according to the random number table method. Patients in the control group were treated with XELOX regimen:on the first day, they were iv administered with Oxaliplatin for injection, 130 mg/m², and also were po administered with Capecitabine Tablets, 1 000 mg/m², twice daily, continuous treatment for 14 d. Patients in the treatment group were iv administered with Tislelizumab Injection on the basis of the control group, 200 mg/time, once every 3 weeks. A course had 3 weeks, and all patients were treated for 3 courses. Recent clinical efficacy, the immune function indicators and serum tumor markers in two groups were compared. Results The total effective rate of the treatment group was higher than that of the control group (P < 0.05). After treatment, CD3⁺T cells, CD4⁺T cells and CD4⁺T/CD8⁺T in control group were significantly decreased, while those in treatment group were significantly increased (P < 0.05). The immune function indicators in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the serum levels of CA199, MMP-2, and VEGF in two groups were significantly decreased (P < 0.05), and the serum levels of tumor markers in the treatment group were lower than those in the control group (P < 0.05). Conclusion Tislelizumab Injection combined with XELOX regimen can improve the short-term efficacy in patients with advanced gastric cancer, promote the recovery of immune function and strengthen the anti-tumor effect.

R979.1

安徽省衛(wèi)生健康委科研項(xiàng)目（AHWJ2021a049）