中性粒细胞/淋巴细胞比值对接受经肝动脉化疗栓塞+甲磺酸仑伐替尼+卡瑞利珠单抗治疗的不可切除肝癌的预后预测意义  

Significance of neutrophil-lymphocyte ratio in predicting the prognosis in unresectable hepatocellular carcinoma patients treated with transarterial chemoembolization,lenvatinib,and camrelizumab

作　　者：朱心睿 张晓赟[1] 彭伟[1] 沈俊颐 卢武胜[1] 陈卫霞[2] 李秋[3] 牟春杨 文天夫[1] ZHU Xinrui;ZHANG Xiaoyun;PENG Wei;SHEN Junyi;LU Wusheng;CHEN Weixia;LI Qiu;MOU Chunyang;WEN Tianfu(Department of Liver Surgery and Liver Transplantation Center,West China Hospital of Sichuan University,Chengdu 610041,P.R.China;Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Department of Medical Oncology,Cancer Center,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院肝脏外科和移植中心,成都610041 [2]四川大学华西医院放射科,成都610041 [3]四川大学华西医院肿瘤中心腹部肿瘤科,成都610041

出　　处：《中国普外基础与临床杂志》2021年第11期1426-1433,共8页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金(项目编号:82070625)。

摘　　要：目的探讨基线中性粒细胞/淋巴细胞比值(NLR)对不可手术肝癌(uHCC)患者接受经肝动脉化疗栓塞(TACE)+仑伐替尼+卡瑞利珠单抗治疗后预后的预测意义。方法回顾性分析2020年6月至2021年5月期间在四川大学华西医院肝脏外科接受TACE+仑伐替尼+卡瑞利珠单抗治疗的58例uHCC患者的临床资料。结果纳入的58例患者中,完全缓解(CR)7例,部分缓解(PR)37例,疾病稳定(SD)11例,疾病进展(PD)3例;所有患者都有不同程度的不良反应,其中1级58例,2级36例,3级35例,4级1例。基于实体肿瘤疗效评价标准(mRECIST)的客观缓解率(ORR)是75.9%(44/58),疾病控制率是94.8%(55/58)。转化切除率是31.0%(18/58),转化成功率是37.9%(22/58)。多因素logistic回归分析结果表明,NLR为ORR的独立危险因素(OR=0.093,P=0.008)。所有患者均获访,随访时间16~60周,中位随访时间为34周。低NLR组的总生存情况(χ^(2)=4.163,P=0.041)和无进展生存情况(χ^(2)=10.626,P=0.001)均优于高NLR组。结论NLR在经TACE+仑伐替尼+卡瑞利珠单抗转化治疗的uHCC患者的预后预测方面有临床意义,值得进一步研究。Objective To investigate the prediction of baseline neutrophil-lymphocyte ratio(NLR)on the prognosis of unresectable hepatocellular carcinoma(uHCC)treated with transarterial chemoembolization(TACE)+lenvatinib+camrelizumab.Method The clinical data of 58 patients treated with TACE+lenvatinib+camrelizumab in the Department of Liver Surgery of West China Hospital of Sichuan University from June 2020 to May 2021 were analyzed retrospectively.Results Among the 58 cases included,7 cases were complete response(CR),37 cases were partial response(PR),11 cases were stable disease(SD),and 3 cases were progressive disease(PD).All cases had different degrees of adverse events,including 58 cases of grade 1,36 cases of grade 2,35 cases of grade 3,and 1 case of grade 4.The overall response rate(ORR)and disease control rate(DCR)based on modified Response Evaluation Criteria in Solid Tumors(mRECIST)were 75.9%(44/58)and 94.8%(55/58),respectively.The hepatectomy rate was 31.0%(18/58)and the conversion success rate was 37.9%(22/58).Multivariate logistic regression analysis showed that NLR was an independent risk factor for ORR(OR=0.093,P=0.008).All cases were followed up for 16–60 weeks,with a median follow-up of 34 weeks.Overall survival situation(χ^(2)=4.163,P=0.041)and progression free survival situation(χ^(2)=10.626,P=0.001)in the low NLR group were better than those of the high NLR group.Conclusion NLR has clinical significance in predicting the prognosis of uHCC cases underwent TACE+lenvatinib+camrelizumab,which is worthy of further study.

关 键 词：肝细胞癌 中性粒细胞/淋巴细胞比值 仑伐替尼 免疫检查点抑制剂 预后 

分 类 号：R735.7[医药卫生—肿瘤]