目的 探讨血清乳酸脱氢酶(LDH)在中晚期肝癌患者接受靶向联合免疫治疗后的预后预测价值。方法 选取2022年1月—2024年8月在莆田学院附属医院肿瘤内科经病理和影像学检查确诊的中晚期肝癌患者作为研究对象。从医院的电子病历系统中收集患者的基线资料,随访截止2025年8月,并记录随访结果,包括患者的疾病缓解情况和死亡情况,以及无疾病进展生存期(PFS)、总生存期(OS)。采用Kaplan-Meier方法绘制不同基线LDH水平患者的OS生存曲线,并通过Log-rank检验比较生存曲线。同时,运用多因素Cox比例风险回归分析探讨影响中晚期肝癌患者在接受靶向联合免疫治疗后OS的相关因素。结果 结果显示,在50例肝癌患者中,基线LDH低于200 U/L的有15例,而高于200 U/L的有35例。与基线LDH<200 U/L组相比,基线 LDH≥200 U/L患者PFS、OS更短,差异均有统计学意义(χ2分别为5.51、15.6,P值分别为0.019、0.017)。治疗8周后,与LDH降低患者相比,LDH升高患者OS更短,差异有统计学意义(χ2=13.2,P=0.04)。多因素Cox比例风险回归分析结果表明,基线LDH水平超过200 U/L是中晚期肝癌患者接受靶向联合免疫治疗后OS的影响因素[P=0.035,HR(95%CI)=5.03(1.12,22.54)]。结论 基线LDH水平较低的患者表现出更好的OS。基线LDH水平可以作为预测中晚期肝癌患者在接受靶向联合免疫治疗时预后的指标。
Objective To evaluate the prognostic significance of serum lactate dehydrogenase(LDH)levels in patients with advanced hepatocellular carcinoma(HCC)undergoing targeted therapy combined immunotherapy.Methods Patients diagnosed with advanced HCC were selected in Putian College Affiliated Hospital from January 2022 to August 2024,diagnosed with pathological and imaging examinations results.Patient baseline data were collected from the hospital’s electronic medical records,with follow-up extending until August 2025.We documented outcomes such as disease response and mortality,along with progression-free survival(PFS)and overall survival(OS).Kaplan-Meier survival curves were constructed based on baseline LDH levels,and the Log-rank test was employed for comparison.Additionally,multivariate Cox proportional hazards regression analysis was conducted to identify factors influencing OS in patients receiving targeted therapy combined immunotherapy.Results Among the 50 patients,15 had baseline LDH levels below 200 U/L,while 35 had levels above.Patients with baseline LDH≥200 U/L had significantly shorter PFS and OS than those with baseline LDH <200 U/L(χ2=5.51 and 15.6 for PFS and OS,respectively;P=0.019 and 0.017,respectively).After 8 weeks of treatment,patients with increased LDH had significantly shorter OS compared with patients with decreased LDH(χ2=13.2,P=0.04).Multivariate Cox proportional hazards regression analysis indicated that a baseline LDH level exceeding 200 U/L is an independent prognostic factor for OS in patients with intermediate to advanced HCC receiving targeted therapy combined with immunotherapy(P=0.035,HR 5.03[1.12,22.54]).Conclusions Patients with lower baseline LDH levels demonstrated better OS,suggesting that baseline LDH can serve as an important prognostic indicator for advanced HCC patients undergoing targeted combined immunotherapy.
目的 探讨益生菌辅助治疗儿童过敏性哮喘的临床疗效,分析其对Th1/Th2免疫失衡、炎症反应、免疫功能及复发风险的影响。方法 选取2022年1月至2023年12月本院收治的80例过敏性哮喘患儿,按随机数字表法分为对照组和观察组,各40例。对照组接受常规抗哮喘治疗(布地奈德雾化吸入+孟鲁司特钠),观察组结合益生菌进行辅助治疗。比较两组肺功能[第1秒用力呼气容积占预计值百分比(FEV1%)、最大呼气峰流速占预计值百分比(PEF%)]、Th1/Th2细胞因子[干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)、白细胞介素-13(IL-13)]以及治疗总有效率、治疗后6个月内复发率。结果 治疗后,观察组FEV1%、PEF%分别为(87.35±5.21)%、(85.62±4.93)%,高于对照组的(78.44±5.67)%、(76.18±5.20)%(P<0.05)。观察组IFN-γ为(32.58±4.12)pg/mL,高于对照组的(24.36±3.89)pg/mL(P<0.05);IL-4、IL-13分别为(18.27±3.06)pg/mL、(22.14±3.51)pg/mL,低于对照组的(25.63±3.74)pg/mL、(31.05±4.02)pg/mL(P<0.05)。观察组治疗总有效率为92.50%(37/40),高于对照组的75.00%(30/40)(P<0.05)。随访6个月,观察组哮喘复发率为10.00%(4/40),低于对照组的27.50%(11/40)(P<0.05)。结论 益生菌辅助治疗儿童过敏性哮喘可显著改善肺功能及临床症状,调节Th1/Th2免疫失衡,提高临床疗效,并降低复发风险,值得临床推广。
目的 研究温肾利水汤联合贝前列素钠对老年原发性肾病综合征(PNS)患者T淋巴细胞亚群及肾功能的影响。方法 回顾性收集我院106例老年PNS患者临床资料(2024年4月-2026年1月),按照不同治疗方法分为研究组(n=55,温肾利水汤联合贝前列素钠)、对照组(n=51,贝前列素钠治疗)。比较两组治疗效果、中医证候积分、治疗前后肾功能[血尿素氮(BUN)、白蛋白(ABL)、血肌酐(SCR)]、T淋巴细胞亚群[CD4+、辅助性T细胞17(Th17)、CD3+]、不良反应。结果 治疗3个月后,研究组总有效率(92.73%)高于对照组(P<0.05);治疗3个月后,研究组主证积分、次证积分均低于对照组(P<0.05);治疗3个月后,研究组血清BUN、SCR水平低于对照组,ABL水平高于对照组(P<0.05);治疗3个月后,研究组CD4+、CD3+高于对照组,Th17低于对照组(P<0.05);两组不良反应发生率(5.45% VS 9.80%)相比,差异无统计学意义(P>0.05)。结论 温肾利水汤联合贝前列素钠治疗老年PNS患者能提高治疗效果,改善T淋巴细胞亚群水平,促进肾功能恢复。
目的 分析沙参麦冬汤联合硫酸羟氯喹对阴虚津亏型原发性干燥综合征(pSS)患者的治疗效果。方法 本研究采用回顾性病例对照研究,选取2023-11—2025-06期间我院确诊的114例pSS阴虚津亏型患者,依据治疗方案不同分成研究组(57例)、对照组(57例)。对照组接受硫酸羟氯喹治疗,研究组接受沙参麦冬汤、硫酸羟氯喹联合治疗,两组持续治疗2个月。观察并对比两组疗效、中医证候积分、外分泌腺功能(泪流量、唾液流率)、临床症状[欧洲抗风湿病联盟干燥综合征患者疾病活动指数(ESSDAI)、欧洲抗风湿病联盟干燥综合征患者报告指数(ESSPRI)]、免疫球蛋白[免疫球蛋白G(IgG)、IgA、IgM]水平。结果 与对照组70.18%相比,研究组治疗有效率91.23%明显较高(P<0.05);治疗2个月,与对照组相比,研究组中医证候积分较低,泪流量、唾液流率较高(P<0.05);治疗2个月后与对照组相比,研究组ESSDAI分值、ESSPRI分值明显较低(P<0.05);治疗2个月后与对照组相比,研究组血清IgG、IgA以及IgM水平明显较低(P<0.05);两组安全性对比,无明显差异(P>0.05)。结论 沙参麦冬汤、硫酸羟氯喹联合治疗阴虚津亏型pSS效果确切,可减轻临床症状,改善免疫功能、外分泌功能,且无明显不良反应。
目的 探究新生儿坏死性小肠结肠炎接受肠腹壁造口术后,对感染指标和免疫指标的影响效果,以及术中、术后不良反应发生情况。方法 选取2016年1月—2024年1月因坏死性小肠结肠炎在潍坊市妇幼保健院接受肠腹壁造口术的56例患儿为A组,另收集同时期因坏死性小肠结肠炎行I期肠切除肠吻合的39例患儿为B组,观察并比较两组患儿术前、术后免疫指标和感染指标的变化情况。另收集同时期40名健康新生儿,对比A组患儿出院前的免疫、感染指标的与健康新生儿差异情况。出院后继续门诊随访,观察术后并发症及不良反应发生情况。结果 A组和B组患儿接受手术后,免疫指标(IgA、IgG、IgM)较术前呈上升趋势,而感染指标(IL-6、PCT、TNF-α)较术前下降。出院前1天A组IgG、IgM水平均高于B组,差异有统计学意义(t=2.312,P=0.023;t=3.214,P=0.002)。B组患儿术后第2天、术后第7天、出院前1天IL-6水平高于A组,差异有统计学意义(t=-4.252,P<0.001;t=-3.383,P=0.001;t=-2.505,P=0.014)。至出院前1天,A组患儿的免疫指标和感染指标与健康新生儿相比,差异无统计学意义(P<0.05)。所有手术患儿住院期间至还纳手术前无严重并发症发生。结论 肠腹壁造口术对患有坏死性小肠结肠炎的患儿治疗效果较好,可在一定程度上减轻炎症反应,改善患儿免疫功能。远期效果较好,安全性良好。
Objective To investigate the effect of enterostomy on infection indexes and immune indexes in necrotizing enterocolitis,as well as the occurrence of enterostomy and postoperative adverse reactions.Methods Fifty-six neonates who underwent enterostomy for necrotizing enterocolitis in Weifang Maternal and Child Health Hospital from January 2016 to January 2024 were selected as Group A,and 39 neonates who underwent phase I intestinal resection and anastomosis for necrotizing enterocolitis during the same period were selected as Group B.The changes of preoperative and postoperative immune indicators and infection indicators between the two groups of neonates were observed and compared.In addition,40 healthy neonates were selected during the same period,and the differences in immune and infection indexes between group A and healthy neonates were compared before discharge.Patients were followed up after discharge to observe postoperative complications and adverse reactions.Results After surgery,the immune indexes(IgA,IgG,IgM)of the two groups(A and B) were higher than those before surgery,while the infection indexes(IL-6,PCT,TNF-α)were significantly lower than those before surgery.The levels of IgG and IgM in Group A were higher than those in Group B one day before discharge,and the differences were statistically significant(t=2.312,P=0.023;t=3.214,P=0.002).In Group B,the levels of IL-6 on postoperative day two,postoperative day seven,and one day before discharge were significantly higher than in Group A.The differences were statistically significant(t=-4.252,P<0.001;t=-3.383,P=0.001;t=-2.505,P=0.014).By one day before discharge,the immune indicators and infection indicators of the infants in Group A were not significantly different from those of healthy newborns.No serious complications occurred among all surgical patients during their hospital stay until the enterostomy closure.Conclusions Enterostomy has a good therapeutic effect on neonates with necrotizing enterocolitis,which can reduce the inflammatory response and improve the immune function of children to a certain exten,with better long-term effects and good safety.
新生儿期的免疫系统发育阶段对维持新生儿健康至关重要,具有独特的免疫调节机制。近年来,人们越来越关注髓源性抑制细胞(MDSCs)在新生儿免疫调节中的作用。MDSCs是一类免疫抑制功能强大的异质性细胞群体,它们能够通过多种机制调节免疫应答。MDSCs在新生儿中的调节作用对防止过度免疫反应和促进免疫耐受至关重要,有助于预防新生儿期炎症性疾病,并对其后续健康产生积极影响。近期研究文献分析展示了MDSCs在新生儿免疫调节中的多种作用机制,包括在特定病理条件下的保护作用、与新生儿期炎症反应的相互作用,以及对长期免疫发展的潜在影响。因此,深入理解MDSCs在新生儿免疫中的角色,不仅有助于揭示其复杂的调节机制,也为制定新的预防和治疗新生儿炎症性疾病的策略提供了新的思路。
The developmental stage of the immune system during the neonatal period is crucial for maintaining neonatal health,characterized by unique immunoregulatory mechanisms.In recent years,increasing attention has been drawn to the role of myeloid-derived suppressor cells(MDSCs)in neonatal immune regulation.MDSCs represents a heterogeneous population of cells with potent immunosuppressive functions,capable of modulating immune responses through various mechanisms.The regulatory role of MDSCs in neonates is vital for preventing excessive immune reactions and promoting immune tolerance,thereby aiding in the prevention of neonatal inflammatory diseases and positively influencing subsequent health outcomes.Analysis of recent research literature reveals multiple mechanisms through which MDSCs contribute to neonatal immune regulation,including protective effects under specific pathological conditions,interactions with neonatal inflammatory responses,and potential impacts on long-term immune development.Therefore,a comprehensive understanding of the role of MDSCs in neonatal immunity not only helps elucidate their intricate regulatory mechanisms but also provides novel insights for developing strategies for the prevention and treatment of neonatal inflammatory diseases.
实体瘤对免疫治疗应答非常有限,因此,如何有效提升肿瘤免疫治疗的疗效,已成为当前肿瘤免疫治疗领域亟待解决的关键难题与挑战。髓系来源抑制性细胞(MDSCs)的趋化募集及其所介导的肿瘤免疫逃逸机制,是制约实体瘤免疫治疗效果的核心因素之一。文章深入探讨了MDSCs的起源、表型特征、其介导肿瘤免疫逃逸的具体机制,以及当前针对MDSCs的靶向治疗策略与将MDSCs靶向疗法与肿瘤免疫治疗相结合的最新研究进展。此外,文章还系统性地分析了靶向MDSCs联合免疫治疗策略所面临的关键挑战,并据此提出了MDSCs的精准靶向策略。这一策略旨在精确激活抗肿瘤免疫反应,为癌症患者提供更为个性化、高效的治疗方案,从而开启肿瘤免疫治疗领域的新纪元,为癌症治疗策略的创新与发展贡献力量。
Solid tumors exhibit a very limited response to immunotherapy.Consequently,effectively enhancing the therapeutic efficacy of tumor immunotherapy has emerged as a critical challenge and problem that urgently needs to be addressed in tumor immunotherapy.The chemotaxis and recruitment of myeloid-derived suppressor cells(MDSCs)and the tumor immune evasion mechanisms mediated by them are one of the core factors that significantly restrict the efficacy of immunotherapy for solid tumors.In this review,we discuss the origins and phenotypic characteristics of MDSCs,the specific mechanisms by which they mediate tumor immune evasion,as well as current targeted therapeutic strategies for MDSCs and the latest research progress in combining MDSC-targeted therapy with tumor immunotherapy.Furthermore,we have systematically analyzed the key challenges faced by the combination of MDSC-targeted and immunotherapy strategies,and accordingly proposed a precise targeting strategy for MDSCs.This strategy aims to precisely activate anti-tumor immune responses,providing more personalized and efficient treatment options for cancer patients,thereby opening a new era in tumor immunotherapy and contributing to the innovation and development of cancer treatment strategies.
目的 探讨单克隆免疫球蛋白血症患者M蛋白质量浓度检测的临床意义。方法 选取2018年6月—2023年6月龙岩人民医院收治的88例单克隆免疫球蛋白血症患者为研究对象,其中意义未明单克隆免疫球蛋白血症(MGUS)21例,具有肾脏意义单克隆免疫球蛋白血症(MGRS)50例,血液系统恶性肿瘤17例。对比其M蛋白质量浓度及临床实验室相关指标表达水平,采用Spearman相关分析法分析临床实验室相关指标的与M蛋白的相关性,对所有患者进行半年随访,以预后情况作为因变量,纳入Logistics回归模型分析M蛋白质量浓度对单克隆免疫球蛋白血症预后的预测价值。结果 不同病种M蛋白水平分别为(2.42±0.55)(2.57±0.64)(4.36±0.64)g/L、24 h尿蛋白分别为(1.45±0.16)(2.98±0.68)(2.43±0.44)g/24 h、血清白蛋白质量浓度分别为(31.01±3.06)(35.03±5.04)(39.05±7.08)g/L、总胆固醇水平分别为(3.42±1.25)(3.87±0.64)、(4.16±0.64)mmol/L、血肌酐水平分别为(114.35±23.23)(81.18±12.12)(146.36±21.12)μmol/L、血红蛋白质量浓度分别为(148.12±15.26)(141.69±12.15)(133.34±15.31)g/L,组间对比差异均有统计学意义(F分别为23.890,19.700,12.044,25.767,36.572,10.267,P<0.05)。MGUS患者24h尿蛋白与M蛋白有相关性(r=-0.384,P=0.033),24 h尿蛋白、血清白蛋白、总胆固醇、血肌酐与MGRS患者M蛋白有相关性(r=-0.586,P=0.006;r=0.431,P=0.018;r=-0.457,P=0.020;r=0.523,P=0.009),血清白蛋白、总胆固醇、血红蛋白与血液系统恶性肿瘤患者M蛋白有相关性(r=0.374,P=0.029;r=-0.617,P=0.001;r=-0.414,P=0.024);年龄、M蛋白为单克隆免疫球蛋白血症患者预后的影响因素(P<0.05)。结论 不同单克隆免疫球蛋白血症患者M蛋白水平存在差异,其中血液系统恶性肿瘤患者的M蛋白水平最高,且M蛋白为单克隆免疫球蛋白血症预后的独立影响因素。
Objective To explore the clinical significance of detecting M protein concentration in patients with monoclonal gammopathy.Methods From June 2018 to June 2023,88 patients with monoclonal gammopathy admitted to the hospital were selected as the study subjects.Among them,21 cases of monoclonal gammopathy with undetermined significance(MGUS),50 cases of monoclonal gammopathy with renal significance(MGRS),and 17 cases of hematological malignancies were selected. Concentration of M protein and the expression levels of clinical laboratory related indicators were compared,Spearman correlation analysis was used to analyze the correlation between clinical laboratory related indicators and M protein.All patients were followed up for six months,with prognosis as the dependent variable,included in the logistic regression model to analyze the predictive value of M protein concentration on the prognosis of monoclonal gammopathy.Results There were significant differences in the expression levels of M protein([2.42±0.55],[2.57±0.64],[4.36±0.64])g/L,24-hour urine protein([1.45±0.16],[2.98±0.68],[2.43±0.44])g/24 h,serum albumin([31.01±3.06],[35.03±5.04],[39.05±7.08])g/L,total cholesterol([3.42±1.25],[3.87±0.64],[4.16±0.64])mmol/L,blood creatinine([114.35±23.23],[81.18±12.12],[146.36±21.12])μmol/L,and hemoglobin([148.12±15.26],[141.69±12.15],[133.34±15.31])g/L among different diseases(F=23.890,19.700,12.044,25.767,36.572,10.267;P<0.05).There was a significant correlation between 24 h urinary protein and M protein in MGUS patients(r=-0.384,P=0.033).Urinary protein,serum albumin,serum cholesterol and blood creatinine were significantly associated with M protein in MGRS patients(r=-0.586,P=0.006;r=0.431,P=0.018;r=-0.457,P=0.020;r=0.523,P=0.009),Serum albumin,total cholesterol,and hemoglobin were significantly associated with M protein in patients with hematological malignancies(r=0.374,P=0.029;r=- 0.617,P=0.001;r=-0.414,P=0.024;P<0.05).Age and M protein were independent risk factors for the prognosis of patients with monoclonal gammopathy(P<0.05).Conclusions There are significant differences in the concentration of M protein among patients with different levels of monoclonal gammopathy,with the highest level observed in patients with hematological malignancies.M protein is an independent prognostic factor for monoclonal gammopathy.
目的 探讨TRIB2在结肠癌中的表达水平及与预后及免疫浸润之间的关系。方法 TIMER数据库分析TRIB2在泛癌种中的表达;TCGA、GSE17538下载结肠癌患者RNA-seq数据和临床信息,评估其与临床病理特征的相关性;生存曲线、单因素和多因素Cox分析探讨TRIB2与预后的相关性,并构建列线图;对TRIB2进行差异基因的富集分析;分析TRIB2表达水平与免疫细胞浸润、免疫检查点、肿瘤突变负荷(TMB)以及免疫治疗敏感性之间的相关性。结果 TRIB2在结肠癌组织中高表达(P<0.05);CMS1结肠癌患者TRIB2 mRNA表达水平最高;TRIB2是结肠癌患者的独立预后因素(单因素Cox回归分析:HR=1.397,95%CI:1.100~1.774,P=0.006;多因素Cox回归分析:HR=1.502,95%CI:1.158~1.947,P=0.002);TRIB2与免疫细胞的浸润密切相关,并且与免疫检查点分子表达水平以及TMB正相关(r=0.39,P<0.001);TRIB2的表达水平与免疫检查点抑制剂的疗效相关。结论 TRIB2在结肠癌中高表达且与结肠癌患者预后差和免疫微环境密切相关。
Objective To explore the expression of TRIB2 in colon cancer and its relationship with prognosis and immune cell infiltration. Methods TIMER database was used to analyse the expression of TRIB2 in pan-cancer.RNA-seq data and clinical information of colon cancer patients were downloaded from TCGA and GSE17538 to assess the correlation between TRIB2 with clinicopathological features.Survival curves,univariate and multivariate COX regression analysis were performed to explore the correlation between TRIB2 and prognosis,and a nomogram was constructed.Gene enrichment analyses were performed for TRIB2.Correlations between TRIB2 expression and immune cell infiltration,immune checkpoints,tumor mutation burden(TMB),and immunotherapy sensitivity were analyzed.Results TRIB2 was highly expressed in colon cancer tissues(P<0.05).The highest level of TRIB2 mRNA expression was found in CMS1.TRIB2 was an independent prognostic factor for colon cancer patients(univariate Cox regression analysis:HR=1.397,95%CI:1.100-1.774,P=0.006;multivariate Cox regression analysis:HR=1.502,95%CI:1.158-1.947,P=0.002).TRIB2 was closely associated with immune cell infiltration and positively correlated with the expression level of immune checkpoint molecules as well as TMB(r=0.39,P<0.001).The expression of TRIB2 was correlated with the efficacy of immune checkpoint inhibitors.Conclusions TRIB2 is highly expressed in colon cancer and is closely associated with poor prognosis and the immune microenvironment of colon cancer patients.
目的 探讨免疫治疗联合化学治疗(化疗)对晚期非小细胞肺癌(NSCLC)患者淋巴免疫及生活质量的影响,为临床进一步治疗提供参考。方法 选择2021年6月—2023年6月天津市滨海新区大港医院收治的晚期NSCLC患者120例进行研究,按抽签法分为干预组及对照组,每组60例,对照组采取单纯化疗方案,干预组采取免疫联合化疗方案,对比两组临床疗效、药物不良反应,治疗前后免疫功能(CD3+、CD4+、CD8+)、糖类抗原199(CA199)、糖类抗原 125(CA125)、血清癌胚抗原(CEA)水平及健康状态调查表(QOL)评分。结果 干预组患者治疗总有效率高于对照组(68.33%>41.67%,P<0.05);治疗后干预组患者CD3+、CD4+比例高于治疗前及对照组治疗后,CD8+比例低于治疗前及对照组治疗后(P<0.05);治疗后干预组血清CA199、CA125、CEA水平均低于治疗前及对照组治疗后(P<0.05);干预组药物不良反应发生率为16.67%,对照组为36.67%,干预组低于对照组(P<0.05);治疗后干预组QOL各维度评分高于对照组及治疗前(P<0.05)。结论 与单纯化疗相比,免疫联合化疗治疗晚期NSCLC患者,能有效降低肿瘤标志物水平,改善患者免疫指标,减轻药物不良反应,提高患者疗效及生活质量。
Objective To explore the effect of immunotherapy combined with chemotherapy on lymphatic immunity and quality of life of patients with advanced non-small cell lung cancer(NSCLC),and to provide reference for further clinical treatment. Methods A total of 120 patients with NSCLC from June 2021 to June 2023 were selected and divided into observation group and control group evenly according to the method of drawing lots,control group was treated with chemotherapy,the observation group was treated with immunotherapy combined with chemotherapy,and the clinical efficacy and adverse drug reactions were compared between the two groups.Before and after treatment,immune function(CD3+,CD4+,CD8+),carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125),serum carcinoembryonic antigen(CEA)levels and health status questionnaire(QOL-RRB- scores)were measured.Results The total effective rate in the observation group was significantly higher than that in the control group(68.33%>41.67%,P<0.05).After treatment,the ratios of CD3+ and CD4+ in the observation group were significantly higher than those before treatment and control group after treatment,and the ratio of CD8+ was significantly lower than that before and after treatment in the control group(P<0.05).After treatment,the serum levels of CA199,CA125 and CEA in the observation group were lower than those before and after treatment in the control group(P<0.05).The incidence of adverse drug reactions was 16.67% in the observation group and 36.67% in the control group,which was significantly lower in the observation group than in the control group(P<0.05).After treatment,the QOL scores in the observation group were significantly higher than those in the control group and before treatment(P<0.05).Conclusions Compared with chemotherapy alone,immunotherapy combined with chemotherapy can effectively reduce the levels of tumor markers,improve the immune indexes of patients,reduce the adverse drug reactions,and improve the efficacy and quality of life of patients with advanced NSCLC.