程序性细胞死亡蛋白-1抑制剂联合仑伐替尼对老年中晚期原发性肝癌患者免疫功能及生存期的影响  

Effect of programmed death-1 inhibitor combined with ranvartinib on immune function and survival time of elderly patients with advanced primary liver cancer

作　　者：付慧英 章柏平[2] 吴文清[1] 张浩利 柯传庆[1] FU Huiying;ZHANG Baiping;WU Wenqing;ZHANG Haoli;KE Chuanqing(Department of Oncology,908 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Nanchang,Jiangxi,330000,China;Outpatient Department,908 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Nanchang,Jiangxi,330000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院肿瘤科,江西南昌330000 [2]中国人民解放军联勤保障部队第九〇八医院门诊部,江西南昌330000

出　　处：《当代医学》2024年第19期60-64,共5页Contemporary Medicine

摘　　要：目的探究程序性细胞死亡蛋白-1(programmed death-1,PD-1)抑制剂联合仑伐替尼对老年中晚期原发性肝癌患者免疫功能及生存期的影响。方法选取2021年1月至2022年5月中国人民解放军联勤保障部队第九O八医院收治的84例老年中晚期原发性肝癌患者作为研究对象,随机分为A组与B组,每组42例。A组应用仑伐替尼治疗,B组应用仑伐替尼联合PD-1抑制剂治疗。比较两组临床疗效、治疗前后免疫细胞水平、血清细胞因子、肝功能指标、中位生存期及毒性反应。结果B组客观缓解率、局部控制率均高于A组,差异有统计学意义(P<0.05);治疗后,B组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于A组,血管内皮生长因子、碱性成纤维细胞生长因子、丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素水平均低于A组,差异有统计学意义(P<0.05);B组中位疾病进展时间长于A组,差异有统计学意义(P<0.05);两组毒性反应总发生率比较差异无统计学意义。结论PD-1抑制剂联合仑伐替尼治疗老年中晚期原发性肝癌患者疗效显著,延长患者生存期,安全性良好,值得临床推广应用。Objective To explore the effect of programmed death-1(PD-1)inhibitor combined with ranvartinib on immune function and survival time of elderly patients with advanced primary liver cancer.Methods 84 elderly patients with advanced primary liver cancer received in 908 Hospital of Joint Logistic Support Force of the Chinese People's Liberation Army from January 2021 to May 2022 were selected as the study subjects,and they were randomly divided into the group A and the group B,with 42 cases in each group.The group A were treated with ranvartinib,and the group B were treated with ranvartinib combined with PD-1 inhibitor.The therapeutic effect,immune cell level,serum cytokine,liver function index,median survival and toxicity were compared between the two groups.Results The objective response rate and local control rate in the group B were higher than those in the group A,and the difference was statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the group B were higher than those the in group A,while the levels of vascular endothelial growth factor,basic fibroblast growth factor,alanine aminotransferase,aspartate aminotransferase and total bilirubin were lower than those in the group A,and the difference was statistically significant(P<0.05).The median disease progression time in the group B was longer than that in the group A,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of toxicity between the two groups.Conclusion PD-1 inhibitor combined with renvastinib is effective in the treatment of elderly patients with advanced primary liver cancer,can improve the therapeutic effect and prolong the survival time of patients with good safety,which is worthy of clinical promotion and applicaiton.

关 键 词：老年中晚期原发性肝癌 PD-1抑制剂 仑伐替尼 

分 类 号：R735.7[医药卫生—肿瘤]