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卡瑞利珠单抗联合阿帕替尼与其联合化疗方案一线治疗晚期胃

癌的临床效果对比
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琚 然 ，缪 琦 ，杨 军 ，王永贵 ，董祥宁 [1.安徽医科大学附属滁州医院（滁州市第一人民医院）南区急诊
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外科，安徽 滁州 239000；2. 安徽医科大学附属滁州医院（滁州市第一人民医院）南区急诊科，安徽 滁州
239000；3.安徽医科大学附属滁州医院（滁州市第一人民医院）北区肿瘤内科，安徽 滁州 239000]
中图分类号 R969.4；R735.2 文献标志码 A 文章编号 1001-0408（2025）18-2307-05
DOI 10.6039/j.issn.1001-0408.2025.18.16

摘 要 目的 对比卡瑞利珠单抗联合阿帕替尼与卡瑞利珠单抗联合化疗方案一线治疗晚期胃癌的临床疗效及安全性。方法 采
用前瞻性随机对照研究设计，将滁州市第一人民医院2022年3月至2024年12月收治的99例晚期胃癌患者按照随机数字表法分
组，其中48例采用卡瑞利珠单抗联合化疗方案治疗（对照组），51例采用卡瑞利珠单抗联合阿帕替尼治疗（观察组）。比较两组患
者治疗后的临床疗效，治疗前后的血清肿瘤标志物[癌胚抗原（CEA）、糖类抗原（CA）724、CA199 和 CA242]和免疫功能指标
（CD3 、CD4 、CD8 及CD4 /CD8）水平，以及治疗期间药物不良反应（ADR）发生情况。结果 观察组和对照组分别有2、3例患者脱
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落。观察组患者的疾病控制率与客观缓解率分别为95.92%、85.71%，分别显著高于对照组的80.00%、55.56%（P＜0.05）。观察组
患者的中位无进展生存期为9.61个月，显著长于对照组的6.72个月（P＝0.011）。治疗前，两组患者的各项血清肿瘤标志物和免疫
功能指标水平比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者的 CEA、CA724、CA199、CA242 水平均显著低于治疗前，
CD3 、CD4 水平及CD4 /CD8 值均显著高于治疗前，且观察组均显著优于对照组（P＜0.05）。两组患者ADR总发生率和严重ADR
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发生率比较，差异均无统计学意义（P＞0.05）。结论 卡瑞利珠单抗联合阿帕替尼作为晚期胃癌一线治疗方案在临床疗效和患者
免疫功能改善方面较卡瑞利珠单抗联合化疗方案具有一定优势，且总体安全性可接受。
关键词 卡瑞利珠单抗；阿帕替尼；晚期胃癌；临床疗效；免疫功能；化疗相关毒性
Clinical efficacy of camrelizumab combined with apatinib versus camrelizumab combined with
chemotherapy regimens as first-line treatment for advanced gastric cancer
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JU Ran ，MIAO Qi ，YANG Jun ，WANG Yonggui ，DONG Xiangning [1. Dept. of Emergency Surgery， South
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Campus， Chuzhou Hospital Affiliated to Anhui Medical University （Chuzhou First People’s Hospital）， Anhui
Chuzhou 239000， China；2. Dept. of Emergency， South Campus， Chuzhou Hospital Affiliated to Anhui Medical
University （Chuzhou First People’s Hospital）， Anhui Chuzhou 239000， China；3. Dept. of Oncology， North
Campus， Chuzhou Hospital Affiliated to Anhui Medical University （Chuzhou First People’s Hospital）， Anhui
Chuzhou 239000， China]
ABSTRACT OBJECTIVE To compare the clinical efficacy and safety of camrelizumab combined with apatinib versus
camrelizumab combined with chemotherapy as first-line treatment for advanced gastric cancer. METHODS A prospective
randomized controlled trial was conducted， enrolling 99 patients with advanced gastric cancer admitted to the Chuzhou First
People’s Hospital from March 2022 to December 2024. Patients were randomly assigned using a random number table： 48 received
camrelizumab plus chemotherapy （control group）， and 51 received camrelizumab plus apatinib （observation group）. Clinical
efficacy， serum tumor marker[carcinoembryonic antigen（CEA），carbohydrate antigen（CA）724，CA199，CA242]levels， immune
function indicators（CD3 ，CD4 ，CD8 ，CD4 /CD8 ） levels before and after treatment， and adverse drug reaction （ADR） during
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treatment were compared between the 2 groups. RESULTS A total of 2 patients in the observation group and 3 in the control group
were lost to follow-up. The disease control rate and objective response rate in the observation group were 95.92% and 85.71%，
respectively， both significantly higher than 80.00% and 55.56% in the control group （P＜0.05）. The median progression-free
survival was 9.61 months in the observation group， significantly longer than 6.72 months in the control group （P＝0.011）. Before
treatment， there was no statistically significant difference in the levels of serum tumor markers and immune function indicators
between the 2 groups （P＞0.05）. After treatment， the levels of CEA， CA724， CA199 and CA242 in 2 groups were significantly
lower than before treatment， while the levels of CD3⁺， CD4⁺
Δ 基金项目 安徽省自然科学基金项目（No.130808MH060）
＊第一作者 主治医师。研究方向：消化道恶性肿瘤的综合治疗。 and CD4 ⁺/CD8 ⁺ were significantly higher than before
treatment， with greater improvements in the observation group
E-mail：jr13955005973@163.com
# 通信作者 副主任医师。研究方向：消化道恶性肿瘤的综合治 （all P＜0.05）. The overall incidences of ADR and severe ADR
疗。E-mail：15955073120@163.com showed no statistically significant difference between the 2

中国药房 2025年第36卷第18期 China Pharmacy 2025 Vol. 36 No. 18 · 2307 ·