PD-1抑制剂及抗血管生成药物联合TACE治疗原发性肝癌的效果  

Effect of PD-1 Inhibitor and Anti-angiogenic Drug Combined with TACE in the Treatment of Primary Liver Cancer

作　　者：丁月超[1] 王谦[1] 姚全军[1] 郑鹏 黄涛[1] DING Yuechao;WANG Qian;YAO Quanjun;ZHENG Peng;HUANG Tao(Department of Hepatobiliary and Pancreatic Surgery,Henan Cancer Hospital,Zhengzhou 450002,China)

机构地区：[1]河南省肿瘤医院肝胆胰外科,河南郑州450002

出　　处：《河南医学研究》2024年第16期3023-3027,共5页Henan Medical Research

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190658)。

摘　　要：目的探究程序性死亡受体-1(PD-1)抑制剂及抗血管生成药物联合经动脉化疗栓塞术(TACE)治疗原发性肝癌的效果。方法纳入原发性肝癌患者58例,均于2019年1月至2022年12月在河南省肿瘤医院就诊,按治疗方法将患者分为对照组(抗血管生成药物联合TACE治疗,30例)与研究组(PD-1抑制剂及抗血管生成药物联合TACE治疗,28例)。两组均治疗9周,比较其疗效、肝功能[碱性磷酸酶(ALP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)]、血管内皮生长因子(VEGF)、可溶性血管细胞黏附因子1(sVCAM1)、免疫指标及不良反应。结果研究组疾病控制率(85.71%)较对照组(60.00%)高(P<0.05);两组治疗后ALP、ALT、AST、TBIL较治疗前低,且研究组较对照组低(P<0.05);两组治疗后VEGF、sVCAM1较治疗前低,且研究组较对照组低(P<0.05);研究组治疗后CD3^(+)、CD4^(+)、CD8^(+)较对照组高,CD4^(+)/CD8^(+)较对照组低(P<0.05);两组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论PD-1抑制剂及抗血管生成药物联合TACE治疗原发性肝癌效果确切,可减少患者肝损伤,改善其免疫功能,且安全性较好。Objective To investigate the efficacy of programmed death receptor-1(PD-1)inhibitors and anti-angiogenic drugs combined with transarterial chemoembolization(TACE)in the treatment of primary liver cancer.Methods Fifty-eight patients with primary liver cancer were included,all of whom were treated in Henan Cancer Hospital from January 2019 to December 2022 and the patients were divided into control group(anti-angiogenic drug combined with TACE treatment,30 cases)and study group(PD-1 inhibitor combined with anti-angiogenic drug combined with TACE treatment,28 cases)according to treatment methods.The two groups were treated for 9 weeks,and the efficacy,liver function[alkaline phosphatase(ALP),alanine transaminase(ALT),aspartate transaminase(AST),total bilirubin(TBIL)],vascular endothelial growth factor(VEGF),soluble vascular cell adhesion molecule 1(sVCAM1),immune indexes and adverse reactions were compared.Results The disease control rate of the study group(85.71%)was higher than that of the control group(60.00%)(P<0.05).After treatment,ALP,ALT,AST and TBIL in two groups were lower than before treatment,and the study group was lower than the control group(P<0.05).VEGF and sVCAM1 were lower in two groups after treatment than before treatment,and the study group was lower than the control group(P<0.05).After treatment,CD3^(+),CD4^(+)and CD8^(+)were higher than before treatment,and CD4^(+)/CD8^(+)was lower than before treatment,and the study group was better than the control group(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusion PD-1 inhibitors and anti-angiogenic drugs combined with TACE are effective in the treatment of primary liver cancer,which can reduce liver injury and improve immune function in patients with good safety.

关 键 词：原发性肝癌 程序性死亡受体-1抑制剂 经动脉化疗栓塞 抗血管生成药物 

分 类 号：R735.7[医药卫生—肿瘤]