卡瑞利珠单抗配合TACE对伴微血管侵犯肝细胞癌患者肿瘤生长转移的影响  

Effect of camrelizumab combined with TACE ontumor growth and metastasis in patients with hepatocellular carcinoma complicated with microvascular invasion

作　　者：魏军[1] 范习刚 肖开美 王春梅[1] 杨斌 WEI Jun;FAN Xigang;XIAO Kaimei;WANG Chunmei;YANG Bin(Department of Oncology, Deyang People's Hospital, Deyang 618000, Sichuan, China)

机构地区：[1]德阳市人民医院肿瘤科,四川德阳618000

出　　处：《西部医学》2022年第7期1031-1035,共5页Medical Journal of West China

基　　金：四川省青年软件创新工程资助项目(2020111)。

摘　　要：目的 探讨卡瑞利珠单抗配合肝动脉栓塞化疗术(TACE)对伴微血管侵犯肝细胞癌(HCC)患者血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、中性粒细胞/淋巴细胞比值(NLR)、乳酸脱氢酶(LDH)水平及肿瘤生长转移的影响。方法 选取2017年12月~2018年12月我院收治的108例伴微血管侵犯HCC患者作为研究对象,按随机数字表法分为观察组和对照组,每组54例。对照组实施TACE治疗方案,观察组在对照组基础上予以卡瑞利珠单抗治疗。比较治疗4周后两组临床疗效,治疗前及治疗4周后两组肿瘤标志物[甲胎蛋白(AFP)、缺氧诱导因子(HIF-1)]、血清学指标[NGAL、NLR、LDH、血管内皮生长因子(VEGF)],治疗后12个月内两组患者不良反应发生情况、复发情况及两年内生存情况。结果 治疗4周后,观察组总缓解率显著高于对照组(P<0.05);两组AFP、HIF-1、NGAL、NLR、LDH、VEGF水平均较治疗前显著降低,且观察组明显低于对照组(均P<0.05)。治疗后12个月内,两组不良反应发生率无显著差异(P>0.05);观察组复发率显著低于对照组(P<0.05)。Kaplan-Meier生存曲线显示,观察组生存时间显著长于对照组(P<0.05)。结论 卡瑞利珠单抗配合TACE对伴微血管侵犯HCC患者具有显著疗效,可促进其肿瘤标志物表达水平下调,抑制肿瘤炎症反应,调节血清NGAL、NLR、LDH水平,降低肿瘤复发率,可延长患者生存时间,具有较高临床应用价值。Objective To explore the effect of camrelizumab combined with transcatheter arterial chemoembolization(TACE)on levels of serum neutrophil gelatinase-associated lipocalin(NGAL),neutrophil-lymphocyte ratio(NLR)and lactate dehydrogenase(LDH)and tumor growth and metastasisin patients with hepatocellular carcinoma(HCC)complicated with microvascular invasion.Methods 108 patients with HCC and microvascular invasion in the hospital between December 2017 and December 2018 were randomly divided into observation group and control group with 54 cases in each group.The control group was given TACE treatment regimen,and the observation group was treated with camrelizumab on the basis of the control group.The clinical efficacy after 4w of treatment,tumor markers[alpha-fetoprotein(AFP),hypoxia-inducible factor(HIF-1)]and serological indicators[NGAL,NLR,LDH,vascular endothelial growth factor(VEGF)]before treatment and after 4w of treatment,occurrence of adverse reactions and recurrence within 12 months after treatment and survival status within 2 years were compared between the two groups of patients.Results After 4wof treatment,the total remission rate of observation group was significantly higher than that of control group(P<0.05).The levels of AFP,HIF-1,NGAL,NLR,LDH and VEGF in the two groups were significantly decreased compared with those before treatment,and the levels of observation group were significantly lower than those of control group at the same time point(P<0.05).Within 12 months after treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The recurrence rate of observation group was significantly lower than that of control group(P<0.05).Kaplan-Meier survival curve showed that the survival time of observation group was significantly longer than that of control group(P<0.05).Conclusion Camrelizumab combined with TACE has a significant efficacy on patients with HCC and microvascular invasion.It can promote the down-regulation of tumor markers,inhibit tumor i

关 键 词：肝细胞癌 微血管侵犯 卡瑞利珠单抗 肝动脉栓塞化疗术 生存情况 

分 类 号：R735.7[医药卫生—肿瘤]