目的 探讨鸦胆子油乳注射液联合注射用紫杉醇（白蛋白结合型）＋卡铂（nab-PC）方案治疗晚期肺腺癌的临床疗效。方法 纳入2022年6月—2025年6月天津市肿瘤医院秦皇岛医院收治的80例晚期肺腺癌患者，按照随机数字表法分为对照组和治疗组，每组各40例。对照组接受nab-PC方案治疗，在对照组基础上，治疗组联合鸦胆子油乳注射液治疗，治疗2个周期（21 d为1个周期）。观察比较两组患者客观缓解率（ORR）、疾病控制率（DCR），治疗前后血清肿瘤标志物、简式简明心境问卷（POMS-SF）评分、癌症治疗功能评价系统-肺癌模块（FACT-L）评分及外周血T淋巴细胞亚群和血清白细胞介素-17（IL-17）、巨噬细胞炎症蛋白-1β（MIP-1β）水平。结果 治疗后，治疗组患者ORR和DCR分别为70.00%和92.50%，较对照组（47.50%和75.00%）均明显升高（P＜0.05）。治疗后，两组血清癌胚抗原（CEA）、细胞角蛋白片段19（CYFR21-1）、糖类抗原125（CA125）及POMS-SF评分均显著降低，而FACT-L评分增加（P＜0.05），且治疗后治疗组血清肿瘤标志物水平优于对照组（P＜0.05）。治疗后，两组外周血CD4⁺/CD8⁺、CD4⁺增高，CD8⁺和血清IL-17、MIP-1β水平均下降（P＜0.05），且治疗组外周血T淋巴细胞亚群水平优于对照组（P＜0.05）。不良反应方面，治疗组血小板减少、恶心呕吐的发生率（17.50%、25.00%）较对照组（37.50%、47.50%）更低（P＜0.05）。结论 在晚期肺腺癌患者的治疗中，联合应用鸦胆子油乳注射液与nab-PC方案可有效调节患者免疫功能，抑制肿瘤相关炎症和侵袭通路，并一定程度减轻毒副反应，利于患者心境、生活质量改善及肿瘤负荷降低。

Objective To explore the clinical efficacy of Yadanzi Oil Emulsion Injection combined with nab-paclitaxel plus carboplatin (nab-PC) regimen in treatment of advanced lung adenocarcinoma. Methods A total of 80 patients with advanced lung adenocarcinoma admitted to Tianjin Cancer Hospital Qinhuangdao Hospital from June 2022 to June 2025 were enrolled and divided into control group and treatment group by random number table method, with 40 patients in each group. The control group received the nab-PC regimen, while the treatment group was given Yadanzi Oil Emulsion Injection on the basis of the control group. Both groups were treated for 2 cycles (21 days per cycle). The objective response rate (ORR), disease control rate (DCR), serum tumor markers before and after treatment, Short-Form Profile of Mood States (POMS-SF) scores, Functional Assessment of Cancer Therapy-Lung (FACT-L) scores, peripheral blood T lymphocyte subsets, and serum levels of interleukin-17 (IL-17) and macrophage inflammatory protein-1β (MIP-1β) were observed and compared between the two groups. Results After treatment, the ORR and DCR of the treatment group were 70.00% and 92.50%, respectively, which were significantly higher than those of the control group (47.50% and 75.00%, P < 0.05). After treatment, the serum levels of carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), carbohydrate antigen 125 (CA125), and POMS-SF scores in two groups were significantly decreased, while the FACT-L scores were significantly increased (P < 0.05); moreover, the serum tumor marker levels in the treatment group were superior to those in the control group after treatment (P < 0.05). After treatment, the peripheral blood CD4⁺/CD8⁺ ratio and CD4⁺ T lymphocyte count were significantly increased, while the CD8⁺ T lymphocyte count and serum levels of IL-17 and MIP-1β were significantly decreased in both groups (P < 0.05), in addition, the levels of peripheral blood T lymphocyte subsets in the treatment group were superior to those in the control group (P < 0.05). In terms of adverse reactions, the incidences of thrombocytopenia and nausea and vomiting in the treatment group (17.50%, 25.00%) were significantly lower than those in the control group (37.50%, 47.50%, P < 0.05). Conclusion In the treatment of patients with advanced lung adenocarcinoma, the combined application of Yadanzi Oil Emulsion Injection and the nab-PC regimen can effectively regulate the immune function of patients, inhibit tumor-related inflammatory and invasive pathways, reduce toxic and side effects to a certain extent, and is conducive to improving patients’ mood and quality of life as well as reducing tumor burden.

R979.1

秦皇岛市重点研发计划科技支撑项目（202301A091）