信迪利单抗联合HAIC治疗中晚期肝细胞癌的疗效及对肿瘤相关凋亡分子、免疫分子的影响  

Efficacy of Sindilizumab Combined with HAIC in the Treatment of Advanced Hepatocellular Carcinoma and its Effect on Tumor-Related Apoptotic Molecules and Immune Molecules

作　　者：孙铭强 吴琴 李妍欣 唐珊 Sun Mingqiang;Wu Qin;Li Yanxin(Department of Oncology,Guangyuan First People's Hospital,Guangyuan,Sichuan 628017,China)

机构地区：[1]广元市第一人民医院肿瘤科,四川广元628017

出　　处：《四川医学》2024年第12期1386-1391,共6页Sichuan Medical Journal

基　　金：2019年四川省医学会(青年创新)科研课题(编号:S19182)。

摘　　要：目的探讨信迪利单抗联合经导管肝动脉灌注化疗(HAIC)治疗中晚期肝细胞癌(HCC)的疗效,并分析其对肿瘤相关凋亡分子、免疫分子的影响。方法选取我院2020年1月至2022年6月HCC患者116例为研究对象,依据随机数字表法分为对照组58例、观察组58例。对照组给予HAIC治疗,在此基础上观察组给予信迪利单抗治疗。比较两组治疗效果、治疗前后肿瘤标志物水平、凋亡分子、免疫分子及不良反应,并随访1年,统计比较两组1年生存率。结果观察组客观缓解率、疾病控制率均高于对照组(P<0.05);观察组治疗6个疗程后血清癌胚抗原(CEA)、糖类抗原199(CA199)、细胞角蛋白19片段(CYFRA21-1)、甲胎蛋白(AFP)水平低于对照组(P<0.05);观察组治疗6个疗程后抗凋亡因子(Livin)、凋亡相关因子B淋巴细胞瘤-2(Bcl-2)蛋白表达水平低于对照组,B淋巴细胞瘤相关X蛋白(Bax)蛋白表达水平高于对照组(P<0.05);观察组治疗6个疗程后血清程序性细胞死亡受体1(PD-1)、程序性细胞死亡配体1(PD-L1)水平低于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05);观察组1年生存率为78.95%,高于对照组的53.57%(χ^(2)=8.150,P=0.004)。结论信迪利单抗联合HAIC治疗中晚期HCC的疗效显著,可控制肿瘤发展进程,促进肿瘤凋亡,减少不良反应发生,提高生存率,可能与抑制PD-1/PD-L1通路活化有关。Objective To investigate the efficacy of the combination of Xindilimab and transcatheter hepatic artery infusion chemotherapy(HAIC)in the treatment of advanced hepatocellular carcinoma(HCC),and to analyze its impact on tumor-related apoptosis molecules and immune molecules.Methods From January 2020 to June 2022,116 HCC patients were selected as research subjects and divided into control group(CP,n=58)and observation group(OG,n=58)according to the random number table method.CG was treated with HAIC,and OG was treated with Xindilimab on this basis.Treatment effects,tumor marker before and after treatment,apoptosis molecules,immune molecules,and adverse reactions were compared.The follow-up was conducted for 1 year,and the 1-year survival rate was statistically compared.Results The objective response rate and disease control rate in OG were higher than those in CG(P<0.05).After six courses of treatment,serum carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),cytokeratin 19 fragment(CYFRA21-1),and alpha-fetoprotein(AFP)in OG were lower than those in CG(P<0.05).After six courses of treatment,anti-apoptosis factor(Livin)and apoptosis-related factor B lymphocyte lymphoma-2(Bcl-2)protein in OG were lower than those in CG,while B lymphocyte lymphoma-associated X protein(Bax)protein was higher than that in CG(P<0.05).After six courses of treatment,serum programmed cell death receptor 1(PD-1)and programmed cell death ligand 1(PD-L1)in OG were lower than those in CG(P<0.05).The incidence of adverse reactions in OG was lower than that in CG(P<0.05).The 1-year survival rate in OG was 78.95%,which was higher than that in CG(53.57%)(χ^(2)=8.150,P=0.004).Conclusion The efficacy of the combination of Xindilimab and HAIC in the treatment of advanced HCC is significant,which could control the progression of tumor development,promote tumor apoptosis,reduce the occurrence of adverse reactions,and improve survival rate,which may be related to the inhibition of PD-1/PD-L1 pathway activation.

关 键 词：肝细胞癌 信迪利单抗 经导管肝动脉灌注化疗 疗效 凋亡 程序性细胞死亡受体1 程序性细胞死亡配体1 

分 类 号：R735.7[医药卫生—肿瘤]