2026 年第 5 期 第 21 卷

免疫检查点抑制剂联合化疗对晚期胃癌及胃食管结合部腺癌患者的临床效果分析

Clinical effect analysis of immune checkpoint inhibitors combined with chemotherapy in patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma

作者：王佳1李栋2李志虎1

英文作者：Wang Jia1 Li Dong2 Li Zhihu1

单位：1甘肃省肿瘤医院消化肿瘤内二科，兰州730000；2甘肃省肿瘤医院胸外一科，兰州730000

英文单位：1Second Department of Gastrointestinal Oncology Gansu Provincial Cancer Hospital Lanzhou 730000 China; 2First Department of Thoracic Surgery Gansu Provincial Cancer Hospital Lanzhou 730000 China

关键词：晚期胃癌；胃食管结合部腺癌；免疫检查点抑制剂；化疗

英文关键词：Advancedgastriccancer;Gastroesophagealjunctionadenocarcinoma;Immunecheckpointinhibitors;Chemotherapy

• 摘要：

• 目的 观察免疫检查点抑制剂联合化疗对晚期胃癌及胃食管结合部腺癌患者的临床效果。方法 收集2021年1月至2025年1月甘肃省肿瘤医院收治的729例晚期胃癌及胃食管结合部腺癌患者的病历进行回顾性分析。依据治疗方案的不同分为对照组（361例，给予常规化疗）和观察组（368例，在对照组基础上联合免疫检查点抑制剂治疗），所有患者均连续治疗3个月观察。对比2组的临床疗效、肿瘤标志物水平、免疫功能指标水平及不良反应的差异。结果 观察组整体疗效及疾病控制率［67.9%（250/368）比47.6%（172/361）］均优于对照组﹙均P<0.001﹚。治疗后，2组癌胚抗原、糖类抗原72-4、糖类抗原199及CD+8水平均低于治疗前且观察组均低于对照组，CD+4水平及CD+4/CD+8比值均高于治疗前且观察组均高于对照组（均P<0.05）。2组Ⅰ～Ⅱ级及Ⅲ～Ⅳ级不良反应发生率差异均无统计学意义（均P>0.05）。结论 对于晚期胃癌及胃食管结合部腺癌的患者，在化疗基础上应用免疫检查点抑制剂的临床效果更好，可提高疾病控制率，降低肿瘤标志物水平，进而使机体免疫功能改善，且不良反应较轻。

• Objective To observe the clinical effect of immune checkpoint inhibitors combined with chemotherapy in patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma. Methods The medical records of 729 patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma admitted to Gansu Provincial Cancer Hospital from January 2021 to January 2025 were collected and retrospectively analyzed. According to different treatment regimens, they were divided into control group (361 cases, received conventional chemotherapy) and observation group (368 cases, received immune checkpoint inhibitors combined with chemotherapy on the basis of control group). All patients were treated continuously for 3 months. The clinical efficacy, levels of tumor markers, immune function indexes and adverse reactions were compared between the two groups. Results The overall response rate and disease control rate ［67.9%(250/368) vs 47.6%(172/361)］ in the observation group were better than those in the control group (both P<0.001). After treatment, the levels of carcinoembryonic antigen, carbohydrate antigen 72-4, carbohydrate antigen 199 and CD+8 in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group; the levels of CD+4 and CD+4/CD+8 ratio in both groups were higher than those before treatment, and those in the observation group were higher than those in the control group (all P<0.05). There were no significant differences in the incidence rates of grade Ⅰ-Ⅱ and Ⅲ-Ⅳ adverse reactions between the two groups (both P>0.05). ConclusionsFor patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma, the application of immune checkpoint inhibitors on the basis of chemotherapy has better clinical efficacy, which can improve the disease control rate, reduce the levels of tumor markers, thereby improving the body′s immune function with mild adverse reactions.