目的 探讨替雷利珠单抗注射液联合XELOX方案治疗晚期胃癌的临床疗效。方法 选取2021年1月—2023年1月泾县医院收治的60例晚期胃癌患者，采用随机数字表法将纳入患者分为对照组和治疗组，每组30例。对照组采用XELOX方案：第1天静脉滴注注射用奥沙利铂130 mg/m²，同时口服卡培他滨片1 000 mg/m²，2次/d，连续治疗14 d，并以3周为1个疗程。治疗组在对照组基础上静脉滴注替雷利珠单抗注射液200 mg/次，3周用药1次，3周为1个疗程。两组患者均连续治疗3个疗程。比较两组近期临床疗效、免疫功能指标和血清肿瘤标志物。结果 治疗组的总有效率高于对照组的总有效率（P＜0.05）。治疗后，对照组CD3⁺T细胞、CD4⁺T细胞和CD4⁺T/CD8⁺T比值均显著降低，治疗组CD3⁺T细胞、CD4⁺T细胞和CD4⁺T/CD8⁺T比值均显著升高（P＜0.05）；治疗组患者CD3⁺T细胞、CD4⁺T细胞和CD4⁺T/CD8⁺T比值均明显高于对照组（P＜0.05）。治疗后，两组血清糖类抗原199（CA199）、基质金属蛋白酶-2（MMP-2）、血管内皮生长因子（VEGF）水平均显著降低（P＜0.05），且治疗组血清CA199、MMP-2、VEGF水平均低于对照组（P＜0.05）。结论 替雷利珠单抗联合XELOX方案可提高晚期胃癌患者的近期疗效，促进免疫功能恢复，加强抗肿瘤效果。

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

安徽省卫生健康委科研项目（AHWJ2021a049）