信迪利单抗联合TACE治疗晚期原发性肝癌的疗效及对T淋巴细胞亚群的影响  

Efficacy of sindilizumab combined with TACE in the treatment of advanced primary liver cancer and its effect on T lymphocyte subsets

作　　者：张龙 岳爱民 段花玲 ZHANG Long;YUE Ai-min;DUAN Hua-ling(Department of Oncology,Xinxiang Central Hospital/the Fourth Clinical College of Xinxiang Medical College,Xinxiang 453000,Henan,CHINA;Department of Gastroenterology,Xinxiang Central Hospital/the Fourth Clinical College of Xinxiang Medical College,Xinxiang 453000,Henan,CHINA)

机构地区：[1]新乡市中心医院/新乡医学院第四临床学院肿瘤外科,河南新乡453000 [2]新乡市中心医院/新乡医学院第四临床学院消化内科,河南新乡453000

出　　处：《海南医学》2025年第3期327-331,共5页Hainan Medical Journal

基　　金：河南省科技发展计划项目(编号:1921023131059)。

摘　　要：目的探讨信迪利单抗联合肝动脉化疗栓塞术(TACE)治疗晚期原发性肝癌的疗效及对T淋巴细胞亚群的影响。方法选择2021年6月至2023年6月新乡市中心医院收治的98例晚期原发性肝癌患者作为研究对象,按照随机数表法分为观察组和对照组,各49例。对照组患者采用TACE治疗,观察组患者在对照组基础上联合信迪利单抗治疗,均以3周为一个疗程,连续治疗3个疗程,均随访1年。治疗3个疗程后,比较两组患者的客观缓解率(ORR)、疾病控制率(DCR);治疗前及治疗3个疗程后,比较两组患者的甲胎蛋白(AFP)、糖类抗原199(CA199)、癌胚抗原(CEA)、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))的变化;比较两组患者治疗期间的不良反应;随访1年后,比较两组患者的无进展生存时间、中位总生存时间和1年生存率。结果治疗后,观察组患者ORR、DCR为57.14%、75.51%,均明显高于对照组的34.69%、55.10%,差异有统计学意义(P<0.05)。治疗前,两组患者的AFP、CA199、CEA水平比较差异均无统计学意义(P>0.05);治疗后,观察组患者AFP、CA199、CEA水平分别为(410.23±73.52)μg/L、(176.40±23.62)U/mL、(21.48±2.73)μg/L,均低于对照组的(489.54±98.47)μg/L、(202.51±32.47)U/mL、(26.99±3.60)μg/L,差异有统计学意义(P<0.05)。治疗前,两组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)比较差异均无统计学意义(P>0.05);治疗后,观察组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)为(53.03±4.47)%、(39.69±3.28)%、0.97±0.14,均高于对照组的(48.96±5.28)%、(36.14±2.87)%、0.85±0.12,差异均有统计学意义(P<0.05)。两组患者治疗期间的不良反应发生率比较差异无统计学意义(P>0.05)。随访1年,观察组患者中有3例失访、对照组有2例失访,观察组患者无进展生存时间、中位总生存时间、生存率为(8.33±1.21)个月、(10.17±1.04)个月、69.57%,均明显长于/高于对照组的(7.12±1.08)个月、(8.76±1.23)个月、48.94%,差异均有Objective To investigate the efficacy of sindilizumab combined with transcatheter arterial chemoembolization(TACE)in the treatment of advanced primary liver cancer and its effect on T lymphocyte subsets.Methods Ninety-eight patients with advanced primary liver cancer admitted to Xinxiang Central Hospital from June 2021 to June 2023 were selected and randomly divided into an observation group and a control group using a random number table method,with 49 patients in each group.Patients in the control group were treated with TACE,while those in the observation group were treated with sindilizumab combined with TACE,continuously for 3 courses,with 3 weeks as one course of treatment.The patients were followed up for 1 year.The two groups were compared in the following items:the objective response rate(ORR)and disease control rate(DCR)after 3 courses of treatment;the levels of alpha fetoprotein(AFP),carbohydrate antigen 199(CA199),and carcinoembryonic antigen(CEA)before and after 3 courses of treatment;the changes in T lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))before and after 3 courses of treatment;the adverse reactions during treatment;the progression-free survival,median overall survival,and 1-year survival rate after a 1-year follow-up.Results After treatment,the ORR and DCR of the observation group were 57.14%and 75.51%,respectively,which were significantly higher than 34.69%and 55.10%of the control group(P<0.05).Before treatment,there was no statistically significant difference in the levels of AFP,CA199,and CEA between the two groups of patients(P>0.05);after treatment,the levels of AFP,CA199,and CEA in the observation group were(410.23±73.52)μg/L,(176.40±23.62)U/mL,and(21.48±2.73)μg/L,respectively,which were significantly lower than(489.54±98.47)μg/L,(202.51±32.47)U/mL,and(26.99±3.60)μg/L in the control group(P<0.05).Before treatment,there was no statistically significant difference in CD3^(+),CD4^(+),CD4^(+)/CD8^(+)between the two groups of patients(P>0.05);after treatment,the CD3^(+),CD4^(

关 键 词：原发性肝癌 晚期 肝动脉化疗栓塞术 信迪利单抗 T淋巴细胞亚群 疗效 

分 类 号：R735.7[医药卫生—肿瘤]