卡瑞利珠单抗配合TACE对伴微血管侵犯肝细胞癌患者根治术后血清Egfl7、VEGF、OPN水平及复发率影响的前瞻性研究  

Effects of camrelizumab combined with transcatheter arterial chemoembolization arterial chemoembolization on serum Egfl7,VEGF,and OPN levels and recurrence rate in patients with hepatocellular carcinoma with microvascular invasion after radical operation:A prospective study

作　　者：黄健翔 骆旭航 龚安安 Jian-Xiang Huang;Xu-Hang Luo;An-An Gong(Department of Hepatobiliary Surgery,Yiwu Central Hospital,Yiwu 322000,Zhejiang Province,China)

机构地区：[1]浙江省义乌市中心医院肝胆胰外科,浙江省义乌市322000

出　　处：《世界华人消化杂志》2021年第4期182-189,共8页World Chinese Journal of Digestology

摘　　要：背景目前,肝癌根治术仍是治疗肝癌患者的最有效方法,术后给予肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗,可进一步清除残留肿瘤组织,可有效改善患者预后.近年来,肝癌的靶向治疗备受临床关注,程序性死亡分子1(PD-1)抑制剂可阻断PD-1与其受体配体的结合,从而重新激活T淋巴细胞,并产生持续的抗肿瘤效应,抑制肿瘤生长.卡瑞利珠单抗作为一种新型PD-1抑制剂逐渐应用于临床.目的探讨卡瑞利珠单抗联合肝动脉化疗栓塞术(TACE)对伴微血管侵犯肝细胞癌患者根治术后血清类表皮生长因子域7(Egfl7)、血管内皮生长因子(VEGF)、骨桥蛋白(OPN)水平及复发率的干预效果.方法选取2019-06/2020-01我院收治的伴微血管侵犯肝细胞癌根治术后患者62例,以简单随机化法分为研究组(n=31)、对照组(n=31).两组均行常规肝癌根治术,术后2 mo内,对照组术后予以TACE治疗,研究组术后予以卡瑞利珠单抗配合TACE治疗.比较两组治疗前、治疗1 mo、3 mo后血清肿瘤标志物[糖类抗原199(CA199)、甲胎蛋白(AFP)、癌胚抗原(CEA)]、免疫功能指标(CD3+、CD4+、CD4+/CD8+)、Egfl7、VEGF、OPN水平和疼痛程度(VAS)、生活质量(QOL-LC),并统计两组不良反应发生率、治疗结束后3 mo、6 mo复发率.结果研究组治疗1 mo、3 mo后血清CA199、AFP、CEA水平低于对照组(P<0.05);研究组治疗1 mo、3 mo后血清CD3+、CD4+、CD4+/CD8+水平高于对照组(P<0.05);研究组治疗1 mo、3 mo后血清Egfl7、VEGF、OPN水平低于对照组(P<0.05);研究组治疗1 mo、3 mo后VAS评分低于对照组,QOL-LC评分高于对照组(P<0.05);研究组反应性毛细血管增生症发生率(61.29%)高于对照组(0.00%)(P<0.05);研究组根治术后3 mo、6 mo复发率(6.45%、9.68%)与对照组(13.33%、23.33%)对比,差异无统计学意义(P>0.05).结论伴微血管侵犯肝细胞癌患者根治术后采用卡瑞利珠单抗配合TACE治疗,能进一步下调血清�BACKGROUND At present,radical resection is still the most effective method for the treatment of patients with liver cancer.Postoperative hepatic transcatheter arterial chemoembolization(TACE)can further remove residual tumor tissue and effectively improve the prognosis of patients.In recent years,targeted therapy of liver cancer has attracted much attention.Programmed-death molecule 1(PD-1)inhibitors can block the binding of PD-1 to its ligand,thus reactivating T lymphocytes and producing sustained anti-tumor effects to inhibit tumor growth.As a new type of PD-1 inhibitor,carrilizumab has been gradually applied in the clinic.AIM To investigate the effect of camrelizumab combined with transcatheter arterial chemoembolization(TACE)on serum epidermal growth factor-like domain 7(Egfl7),vascular epithelial growth factor(VEGF),and osteopontin(OPN)levels and recurrence rate of patients with hepatocellular carcinoma with microvascular invasion after radical operation.METHODS A total of 62 patients with hepatocellular carcinoma with microvascular invasion who were admitted to our hospital from June 2019 to January 2020 were selected.They were divided into either a study group(n=31)or a control group(n=31)by simple randomization method.Both groups underwent conventional radical resection of liver cancer.Within 2 mo after surgery,the control group received TACE after surgery,and the study group received camrelizumab+TACE after surgery.Serum levels of tumor markers[carbohydrate antigen 199(CA199),alphafetoprotein(AFP),and carcinoembryonic antigen(CEA)],immune function indicators(CD3+,CD4+,and CD4+/CD8+),serum levels of Egfl7,VEGF,and OPN,pain degree(VAS),and quality of life(QOL-LC)before treatment and 1 mo and 3 mo after treatment were compared between the two groups.The incidence of adverse reactions in the two groups and the recurrence rate at 3 mo and 6 mo after the end of treatment were also calculated.RESULTS At 1 mo and 3 mo after treatment,serum levels of CA199,AFP,and CEA in the study group were significantly lower t

关 键 词：肝细胞癌 微血管侵犯 卡瑞利珠单抗 肝动脉化疗栓塞术 类表皮生长因子域7 血管内皮生长因子 骨桥蛋白 

分 类 号：R735.7[医药卫生—肿瘤]