目的 探讨信迪利单抗注射液联合GP方案（吉西他滨＋顺铂）治疗晚期非小细胞肺癌恶性胸腔积液的临床疗效。方法 选取2024年2月—2025年3月在青岛市第八人民医院就诊的晚期非小细胞肺癌恶性胸腔积液共计82例，将患者按随机数字表法分对照组和治疗组，每组41例。对照组使用GP方案治疗，第1～5天静脉滴注顺铂注射液30 mg/m²，1次/d；静脉滴注注射用盐酸吉西他滨1 000 mg/m²，1次/周。治疗组在对照组基础上静脉滴注信迪利单抗注射液，2支/次。3周为1个疗程，两组患者完成4个疗程。比较两组的治疗效果、生活质量评分、积液量、胸腔积液肿瘤标志物、血清指标。结果 治疗组的总有效率为82.93%，对照组的总有效率为63.41%，组间比较有明显差异（P＜0.05）。两组治疗后肺癌患者生命质量测定量表（QLQ-LC43）评分明显增大，积液量均明显减少（P＜0.05）；治疗组治疗后的QLQ-LC43评分高于对照组，积液量明显低于对照组（P＜0.05）。两组治疗后的胸腔积液癌胚抗原（CEA）、人附睾分泌蛋白4（HE4）、神经元特异性烯醇化酶（NSE）水平显著降低（P＜0.05）；治疗组治疗后的胸腔积液CEA、HE4、NSE水平低于对照组（P＜0.05）。两组治疗后的血清基质金属蛋白酶-9（MMP-9）、血管生成素-2（Ang-2）、血管内皮生长因子（VEGF）水平明显降低（P＜0.05），治疗组治疗后血清MMP-9、Ang-2、VEGF水平明显低于对照组（P＜0.05）。结论 信迪利单抗注射液联合GP方案可提高晚期非小细胞肺癌恶性胸腔积液的临床疗效，改善患者生活质量，减少积液量，降低肿瘤标志物水平，抑制血管形成。

Objective To investigate the clinical efficacy of Sintilimab Injection combined with GP regimen (gemcitabine + cisplatin) in treatment of malignant pleural effusions in advanced non-small cell lung cancer. Methods 82 Cases of advanced non-small cell lung cancer malignant pleural effusion treated at Qingdao Eighth People's Hospital from February 2024 to March 2025 were selected. The patients were divided into control group and treatment group using a random number table method, with 41 cases in each group. The control group was treated with GP regimen. Patients in the control group received intravenous infusion of Cisplatin Injection at a dose of 30 mg/m² from day 1 to day 5, once daily, and also intravenous infusion of Gemcitabine Hydrochloride for injection at a dose of 1 000 mg/m², once weekly. The treatment group received intravenous infusion of Sintilimab Injection in addition to the control group, 2 doses per time. One course of treatment was three weeks, and two groups of patients completed four courses. The treatment efficacy, quality of life score, effusion volume, pleural effusion tumor markers, and serum indicators were compared between two groups. Results The total effective rate of the treatment group was 82.93%, while the total effective rate of the control group was 63.41%, and there was a significant difference between the groups (P< 0.05). After treatment, the quality of life measurement scale (QLQ-LC43) scores in two groups significantly increased, but the effusion volume significantly decreased (P < 0.05). The QLQ-LC43 score of the treatment group was higher than that of the control group after treatment, but the amount of fluid accumulation was significantly lower than that of the control group (P < 0.05). After treatment, the levels of carcinoembryonic antigen (CEA), human epididymal secretory protein 4 (HE4), and neuron specific enolase (NSE) in pleural effusion were significantly reduced in two groups (P< 0.05). The levels of CEA, HE4, and NSE in the pleural effusion of the treatment group were lower than those of the control group after treatment (P< 0.05). After treatment, the serum levels of matrix metalloproteinase-9 (MMP-9), angiopoietin-2 (Ang-2), and vascular endothelial growth factor (VEGF) in two groups were significantly reduced (P < 0.05). The serum levels of MMP-9, Ang-2, and VEGF in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The combination of Sintilimab Injection and GP regimen can improve the clinical efficacy of malignant pleural effusion in advanced non-small cell lung cancer, improve patients' quality of life, reduce fluid volume, lower tumor marker levels, and inhibit angiogenesis.

R979.1

济南市卫生局科技计划项目（201820047）