摘要目的:分析信迪利单抗联合依托泊苷+顺铂注射液(EP)方案治疗广泛期小细胞肺癌的临床效果。方法:抽取2019年1月至2021年1月焦作市第二人民医院收治的广泛期小细胞肺癌患者90例，按随机数字表法分为联合组与化疗组，每组45例。化疗组采用EP方案化疗，联合组在化疗组基础上采用信迪利单抗治疗。比较两组临床效果、不良反应发生率、治疗前后血管内皮生长因子水平[血管内皮生长因子-A(VEGF-A)、血管内皮生长因子-C(VEGF-C)]、血清肿瘤标志物水平[基质金属蛋白酶9(MMP-9)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段抗原21-1(CY211)]及卡氏评分(KPS)。结果:联合组总有效率(75.56%，34/45)高于化疗组(46.67%，21/45)， P<0.05。治疗后，联合组血清VEGF-A、VEGF-C水平低于化疗组( P<0.05)；联合组血清MMP-9、NSE、CY211水平低于化疗组( P<0.05)。联合组血小板减少、消化道反应、恶心呕吐、粒细胞减少发生率分别为20.00%(9/45)、17.78%(8/45)、22.22%(10/45)、42.22%(19/45)，与化疗组的17.78%(8/45)、24.44%(11/45)、26.67%(12/45)、48.89%(22/45)相比，差异未见统计学意义( P>0.05)。治疗后，两组KPS评分均较治疗前增高，且联合组KPS评分高于化疗组( P<0.05)。 结论:信迪利单抗联合EP方案治疗广泛期小细胞肺癌可提高临床效果，抑制血管内皮生长因子表达，下调血清肿瘤标志物水平，恢复机体体力和功能状况，且安全性好。

abstractsObjective:To analyze the clinical effect of sintilimab combined with etoposide and cisplatin injection (EP) regimen in the treatment of extensive small cell lung cancer.Methods:A total of 90 patients with extensive small cell lung cancer treated in Jiaozuo Second People’s Hospital from January 2019 to January 2021 were selected, and they were divided into combination group and chemotherapy group according to the random number table method, with 45 cases in each group. The chemotherapy group was treated with EP regimen, and the combination group was treated with sintilimab on the basis of the chemotherapy group. The clinical effects, incidence of adverse reactions, vascular endothelial growth factors, including vascular endothelial growth factor-A (VEGF-A) and vascular endothelial growth factor-C (VEGF-C), serum tumor marker levels, such as matrix metalloproteinase-9 (MMP-9), neuron-specific enolase (NSE), cytokeratin 19 fragment antigen 21-1 (CY211), and Karnofsky score (KPS) before and after treatment were compared between the two groups.Results:The total effective rate of the combination group was 75.56% (34/45), higher than the 46.67% (21/45) of the chemotherapy group ( P<0.05). After treatment, the serum VEGF-A and VEGF-C levels in the combination group were lower than those in the chemotherapy group ( P<0.05), the serum levels of MMP-9, NSE and CY211 in the combination group were lower than those in the chemotherapy group ( P<0.05). The incidence of thrombocytopenia, gastrointestinal reactions, nausea and vomiting, and neutropenia in the combination group were 20.00% (9/45), 17.78% (8/45), 22.22% (10/45), 42.22% (19/45), respectively, which had no significant difference in comparison with the 17.78% (8/45), 24.44% (11/45), 26.67% (12/45), 48.89% (22/45) in chemotherapy group ( P>0.05). After treatment, the KPS scores of the two groups were higher than those before treatment, and the KPS score of the combination group was higher than that of the chemotherapy group ( P<0.05). Conclusions:Sintilimab combined with EP regimen in the treatment of extensive small cell lung cancer can improve the clinical effect, inhibit the expression of vascular endothelial growth factor, lower the level of serum tumor markers, restore physical strength and functional status, with good safety.