【摘要】 目的 探讨替雷利珠单抗在驱动基因阴性晚期肺鳞状细胞癌患者一线治疗中的应用效果。方法 根据随机数字表法将86例驱动基因阴性晚期肺鳞状细胞癌患者分为观察组（替雷利珠单抗联合含铂双药化疗）与对照组（单纯含铂双药化疗），每组43例。比较两组患者肿瘤标志物[癌胚抗原、神经元特异性烯醇化酶（NSE）、鳞状细胞癌抗原（SCCA）]、免疫检查点指标[可溶性转化生长因子-β(sTGF-β)、可溶性细胞毒性T淋巴细胞相关蛋白4(s CTLA4)、可溶性程序性死亡受体配体1(sPD-L1)、可溶性半乳糖凝集素-9(sGal-9)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表（EORTC QLQ-C30）]及不良反应发生情况。结果 治疗2个周期后，两组患者癌胚抗原、NSE、SCCA、sTGF-β、sCTLA4、sPD-L1、sGal-9水平均较治疗前降低，且观察组患者癌胚抗原、NSE、SCCA、s TGF-β、s CTLA4、sPD-L1、sGal-9水平均低于对照组，差异均有统计学意义（P﹤0.05）。治疗2个周期后，两组患者功能子量表、症状子量表评分及总分均较治疗前升高，且观察组患者功能子量表、症状子量表评分及总分均高于对照组，差异均有统计学意义（P﹤0.05）。两组患者各不良反应发生率比较，差异均无统计学意义（P﹥0.05）。结论 替雷利珠单抗联合含铂双药化疗用于驱动基因阴性晚期肺鳞状细胞癌患者一线治疗，可有效降低肿瘤标志物水平并抑制可溶性免疫检查点指标的异常表达，同时显著改善患者的生活质量，且不增加常见不良反应的发生风险。更多还原

【Abstract】 Objective To explore the application effect of tislelizumab in the first-line treatment of patients with driver gene-negative advanced lung squamous cell carcinoma. Method According to the random number table method, 86 patients with driver gene-negative advanced lung squamous cell carcinoma were divided into the observation group(tislelizumab combined with platinum-based dual-drug chemotherapy) and the control group(platinum-based dual-drug chemotherapy), with 43 cases in each group. The tumor markers [carcinoembryonic antigen, neuron specific enolase(NSE), squamous cell carcinoma antigen(SCCA)], immune checkpoint indicators [soluble transforming growth factor-β(sTGF-β), soluble cytotoxic T-lymphocyte associated protein 4(sCTLA4), soluble programmed cell death 1 ligand 1(sPD-L1), soluble galectin-9(sGal-9)], quality of life [European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)] and the incidence of adverse reactions of the two groups were compared. Result After two cycles of treatment, the levels of carcinoembryonic antigen, NSE, SCCA, sTGF-β, sCTLA4,sPD-L1, and s Gal-9 in both groups were lower than those before treatment, the levels of carcinoembryonic antigen, NSE,SCCA, sTGF-β, s CTLA4, sPD-L1 and sGal-9 in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). After two cycles of treatment, the scores of the functional subscales, symptom subscales and the total scores of both groups were higher than those before treatment, the scores of the functional subscales, symptom subscales and the total score of the observation group were higher than those of the control group, and the differences were statistically significant(P<0.05). There were no statistically significant differences in the incidence of each adverse reactions between the two groups(P>0.05). Conclusion Tislelizumab combined with platinum-based dual-drug chemotherapy for the first-line treatment of patients with driver gene-negative advanced lung squamous cell carcinoma can effectively reduce the levels of tumor markers and inhibit the abnormal expression of soluble immune checkpoint indicators. At the same time, it significantly improve the quality of life of patients without increasing the risk of common adverse reactions.更多还原