摘要目的:探讨免疫检查点抑制剂同步化疗治疗非小细胞肺癌（NSCLC）的效果以及该方案对患者血清肿瘤标志物水平、免疫细胞水平的影响。方法:回顾性分析2020年2月至2022年2月徐州市肿瘤医院60例NSCLC患者临床资料，按治疗方法分为化疗联合免疫检查点抑制剂治疗组（联合治疗组）和常规化疗组，各30例。治疗前及治疗后6周，采用化学发光免疫分析法检测患者血清癌胚抗原（CEA）、糖类抗原125（CA125）、血管内皮生长因子（VEGF）、细胞角蛋白19片段抗原21-1（CYFRA21-1）水平，采用双抗体夹心酶联免疫吸附试验检测血清肿瘤性M2丙酮酸激酶（TuM2-PK）、脂肪酸合成酶（FAS）水平，采用流式细胞术测定T细胞亚群水平，依据世界卫生组织简易生命质量量表（WHOQOL-BREF）评估患者生命质量。比较两组临床疗效、肿瘤标志物水平、免疫细胞水平、生命质量及不良反应发生情况。结果:联合治疗组患者总有效率为46.67%（14/30），高于常规化疗组的20.00%（6/30）（ χ2＝4.80， P＝0.029）。治疗前两组间血清CEA、CA125、VEGF、CYFRA21-1、TuM2-PK、FAS水平及CD3 +、CD4 +、CD8 + T细胞比例、WHOQOL-BREF评分差异均无统计学意义（均 P>0.05）；两组治疗后6周的CEA、CA125、VEGF、CYFRA21-1、TuM2-PK、FAS水平及CD8 + T细胞比例均低于治疗前（均 P<0.05），CD3 +、CD4 + T细胞比例和WHOQOL-BREF评分均高于治疗前（均 P<0.05）；联合治疗组治疗后6周CEA、CA125、VEGF、CYFRA21-1、TuM2-PK、FAS水平及CD8 + T细胞比例均低于常规化疗组治疗后6周（均 P<0.001），CD3 +、CD4 + T细胞比例和WHOQOL-BREF评分均高于常规化疗组治疗后6周（均 P<0.05）。两组患者的胃肠道反应、脱发、白细胞减少、血小板减少、肝肾功能受损发生率差异均无统计学意义（均 P>0.05）。 结论:NSCLC患者免疫检查点抑制剂联合化疗治疗效果较常规化疗好，联合治疗能更有效降低患者血清肿瘤标志物水平，增强抗肿瘤免疫效应，不良反应与常规化疗相当。

abstractsObjective:To investigate the effect of immune checkpoint inhibitors combined with concurrent chemotherapy for non-small cell lung cancer (NSCLC) and the effect of this regimen on serum levels of tumor marker and immune cells of patients.Methods:The clinical data of 60 NSCLC patients in Xuzhou Cancer Hospital from February 2020 to February 2022 were retrospectively analyzed, and they were divided into chemotherapy combined with immune checkpoint inhibitor treatment group (combination treatment group) and conventional chemotherapy group by treatment methods, with 30 cases in each group. Before treatment and 6 weeks after treatment, the patients' serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), vascular endothelial growth factor (VEGF), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) were detected by chemiluminescence immunoassay, and the levels of serum tumorous M2 pyruvate kinase (TuM2-PK) and fatty acid synthase (FAS) were detected by double-antibody sandwich enzyme-linked immunosorbent assay. The levels of T cell subsets were measured by flow cytometry, and the quality of life of patients was evaluated according to the World Health Organization quality of life scale brief version (WHOQOL-BREF). The clinical efficacy, tumor markers levels, immune cells levels, quality of life and adverse reactions were compared between the two groups.Results:The overall effective rate of patients in the combination treatment group was 46.67% (14/30), which was higher than 20.00% (6/30) in the conventional chemotherapy group ( χ2 = 4.80, P = 0.029). The differences in serum CEA, CA125, VEGF, CYFRA21-1, TuM2-PK, FAS levels and the proportions of CD3 +, CD4 +, CD8 + T cells and WHOQOL-BREF scores between the two groups before treatment were not statistically significant (all P > 0.05); the levels of CEA, CA125, VEGF, CYFRA21-1, TuM2-PK, FAS and the proportion of CD8 + T cells at 6 weeks after treatment were lower than those before treatment in both groups (all P < 0.05), and the proportions of CD3 + and CD4 + T cells and WHOQOL-BREF scores were higher than those before treatment (all P < 0.05); the levels CEA, CA125, VEGF, CYFRA21-1, TuM2-PK and the proportions of CD8 + T cells in the combination treatment group at 6 weeks after treatment were higher than those in the conventional chemotherapy group at 6 weeks after treatment (all P < 0.001), and the proportions of CD3 + and CD4 + T cells and WHOQOL-BREF scores were higher than those in the conventional chemotherapy group at 6 weeks after treatment (all P < 0.05). The differences in the incidence of gastrointestinal reactions, alopecia, leukopenia, thrombocytopenia, and liver and kidney function impairment between the two groups were not statistically significant (all P > 0.05). Conclusions:Immune checkpoint inhibitors combined with chemotherapy in NSCLC patients are more effective than conventional chemotherapy, and the combined treatment can more effectively reduce the serum tumor marker levels of patients and enhance the anti-tumor immune effect, with the adverse reactions comparable to conventional chemotherapy.