奥希替尼辅助治疗对晚期非小细胞肺癌患者疗效及CCR7 TGF-β<sub>1</sub> CXCR5水平的影响

doi:10.3969/j.issn.1006-6233.2025.12.012

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摘要 目的: 探究奥希替尼辅助DP方案治疗对晚期非小细胞肺癌(NSCLC)患者的临床疗效,并观察CC趋化因子受体(C-C chemokine receptor,CCR)7、转化生长因子(Transforming growth factor,TGF)β₁、C-X-C基序趋化因子受体(C-X-C chemokine receptor,CXCR5)水平的变化情况,为该药物临床应用提供科学证据。方法: 回顾性分析2021年1月至2022年12月于我院就诊的98例晚期NSCLC患者临床资料,按照治疗方法分为两组,对照组(n=47)基于DP方案(多西他赛+顺铂)予以阿法替尼治疗,观察组(n=51)基于DP方案予以奥希替尼治疗。评价两组治疗3个周期的临床疗效与用药安全性,统计随访2年内的生存率,观察治疗前后免疫功能指标[白细胞表面分化抗原3(CD3⁺)、CD4⁺、CD8⁺、CD4⁺/CD8⁺]与CCR7、TGF-β₁、CXCR5水平的变化情况,并分析其差异。结果: 观察组客观缓解率与疾病控制率(52.94%、88.24%)均高于对照组(32.65%、72.34%)(P<0.05)。治疗3个月后,两组CD3⁺、CD4⁺水平与CD4⁺/CD8⁺均升高,且观察组均高于对照组(P<0.05),CD8⁺水平均降低,且观察组均低于对照组(P<0.05)。两组治疗1个周期、2个周期、3个周期后CCR7、TGF-β₁与CXCR5均低于治疗前,且观察组在上述时间点均低于对照组(P<0.05)。观察组随访1年、2年总生存率(70.59%、41.18%)均高于对照组(51.06%、21.28%)(P<0.05)。结论: 相较于阿法替尼,奥希替尼辅助DP方案治疗对晚期NSCLC患者,具有提高近期临床疗效与免疫功能,改善远期生存率的作用,能有效下调CCR7、TGF-β₁、CXCR5水平,且具有安全性。

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	赵敏
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关键词 ：非小细胞肺癌, 晚期, 奥希替尼, DP方案, 趋化因子受体7, 转化生长因子β₁, CXC趋化因子受体5

Abstract：Objective: To explore the clinical efficacy of osimertinib-adjuvant DP regimen in the treatment of patients with advanced non-small cell lung cancer (NSCLC), and to observe the changes of CCR7, TGF-β₁ and CXCR5 levels, so as to provide scientific evidence for the clinical application of this drug. Methods: A retrospective analysis was conducted on clinical data from 98 patients with advanced NSCLC treated at our hospital from Januaryr 2021 to December 2022. The patients were divided into two groups based on treatment regimens: the control group (n=47) received afatinib in combination with the DP regimen (docetaxel+cisplatin), while the observation group (n=51) received osimertinib in combination with the DP regimen. The clinical efficacy and drug safety of the two groups were evaluated after 3 cycles of treatment. The survival rate within 2 years of follow-up was counted. The changes of immune function indexes [cluster of differentiation antigen 3 (CD3⁺), CD4⁺, CD8⁺, CD4⁺/CD8⁺] and CCR7, TGF-β₁ and CXCR5 before and after treatment were observed, and the differences were analyzed. Results: The objective remission rate and disease control rate (52.94%, 88.24%) in observation group were higher than (32.65%, 72.34%) in control group (P<0.05). After 3 cycles of treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the two groups were increased, and the levels in observation group were higher than those in control group (P<0.05), and the levels of CD8⁺ was decreased, and the levels in observation group were lower (P<0.05). The levels of CCR7, TGF-β₁ and CXCR5 after 1 cycle, 2 cycles and 3 cycles of treatment in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group at the above time points (P<0.05). The overall survival rates within 1 year and 2 years of follow-up in observation group (70.59%, 41.18%) were higher than those in control group (51.06%, 21.28%) (P<0.05). Conclusion: Compared with afatinib, Osimertinib-adjuvant DP regimen in the treatment of patients with advanced NSCLC can indeed enhance the short-term clinical efficacy and immune function, improve the long-term survival rate, and can effectively down-regulate the levels of CCR7, TGF-β₁ and CXCR5, with safety.

Key words： Non-small cell lung cancer Advanced Osimertinib DP regimen Chemokine receptor 7 Transforming growth factor β₁ CXC chemokine receptor 5

基金资助:陕西省自然科学基础研究计划,(编号:2022JQ-873)

通讯作者: 周晓燕

引用本文:

赵敏, 周晓燕, 张艳青, 姜琳. 奥希替尼辅助治疗对晚期非小细胞肺癌患者疗效及CCR7 TGF-β₁ CXCR5水平的影响[J]. 河北医学, 2025, 31(12): 2014-2019.
ZHAO Min, ZHOU Xiaoyan, ZHANG Yanqing, et al. Effect of Adjuvant Therapy with Osimertinib on the Efficacy and Levels of CCR7 TGF-β₁ and CXCR5 in Patients with Advanced Non-Small Cell Lung Cancer. HeBei Med, 2025, 31(12): 2014-2019.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.12.012 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I12/2014

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