阿替利珠单抗联合射频消融术治疗不可切除的肝细胞癌患者临床疗效和安全性研究  

Efficacy and safety of radiofrequency ablation plus atezolizumab in the treatment of patients with unresectable hepatocellular carcinoma

作　　者：严隽瑶 尹国文[1] 徐清宇 尤然 秦锦霞 Yan Junyao;Yin Guowen;Xu Qingyu(Provincial Institute of Cancer Research,Department of Interventional Therapy,Provincial Tumor Hospital,Affiliated to Nanjing Medical University,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京医科大学附属江苏省肿瘤医院介入治疗科/江苏省肿瘤防治研究所,南京市210000 [2]南京医科大学附属江苏省肿瘤医院影像中心/江苏省肿瘤防治研究所,南京市210000

出　　处：《实用肝脏病杂志》2025年第2期262-265,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金资助项目(编号:81701803)。

摘　　要：目的探讨应用阿替利珠单抗联合射频消融术(RFA)治疗不可切除的肝细胞癌(HCC)患者的临床疗效和安全性。方法2022年3月~2024年4月我院收治的不可切除的HCC患者112例,被随机分为对照组56例,接受RFA治疗,和观察组56例,接受阿替利珠单抗联合RFA治疗。采用ELISA法检测血清干扰素γ(IFN-γ)、转化生长因子β1(TGF-β1)、白介素10(IL-10)和IL-4水平,使用流式细胞术检测外周血淋巴细胞亚群,应用生活质量量表(QLQ-C30)评估生活质量。结果在治疗后,观察组疾病控制率和客观缓解率分别为89.3%和57.1%,均显著高于对照组的64.3%和35.7%(P<0.05);观察组血清IFN-γ、IL-4和IL-10水平分别为(255.3±10.2)ng/mL、(45.3±5.4)μg/mL和(25.5±3.2)μg/mL,均显著高于对照组【分别为(229.9±10.0)ng/mL、(34.6±4.3)μg/mL和(20.2±2.8)μg/mL,P<0.05】,而血清TGF-β1水平为(21.2±3.7)μg/mL,显著低于对照组【(28.2±3.0μg/mL,P<0.05】;观察组外周血CD3^(+)和CD4^(+)T细胞百分比和CD4^(+)/CD8^(+)细胞比值分别为(64.1±5.1)%、(33.8±2.8)%和(1.3±0.2),均显著高于对照组【分别为(57.9±5.0)%、(29.0±2.7)%和(1.0±0.2),P<0.05】;观察组QLQ-C30评分显著优于对照组(P<0.05);观察组不良反应发生率为33.9%,显著高于对照组为12.5%(P<0.05)。结论应用阿替利珠单抗联合RFA治疗不可切除的HCC患者具有较好的短期临床疗效,能够提高生活质量,可能与改善了机体免疫功能有关。Objective The aim of this study was to investigate clinical efficacy and safety of radiofrequency ablation(RFA)plus atezolizumab in the treatment of patients with unresectable hepatocellular carcinoma(HCC).Methods A total of 112 patients with unresectable HCC were encountered in our hospital between March 2022 and April 2024,and were randomly assigned to receive RFA in 56 cases,or receive FRA plusatezolizumab combination therapy.Serum interferon-γ,transforming growth factor-β1(TGF-β1),interleukin-10(IL-10)and IL-4 levels were detected by ELISA,peripheral blood lymphocyte subsets were determined by FCA,and quality of life(QOL)was assessed byQLQ-C30 questionaire.Results After treatment,disease control rate and objective remission rate in the combination group were89.3%and 57.1%,both much higher than 64.3%and 35.7%(P<0.05)in the control;serum IFN-γ,IL-4 and IL-10 levels were(255.3±10.2)ng/mL,(45.3±5.4)μg/mL and(25.5±3.2)μg/mL,all significantly higher than[(229.9±10.0)ng/mL,(34.6±4.3)μg/mL and(20.2±2.8)μg/mL,respectively,P<0.05],while serum TGF-β1 level was(21.2±3.7)μg/mL,significantly lower than[(28.2±3.0μg/mL,P<0.05]in the control group;percentages of peripheralblood CD3^(+)and CD4^(+)T cells,and ratio of CD4^(+)/CD8^(+)cells were(64.1±5.1)%,(33.8±2.8)%and(1.3±0.2),all significantly higher than[(57.9±5.0)%,(29.0±2.7)%and(1.0±0.2),respectively,P<0.05]in the control;improvement of quality of life in the combination group was much superior to that in the control(P<0.05);incidence of adverse effect in the combination group was 33.9%,much higher than 12.5%(P<0.05)in the control group.Conclusion RFA plus atezolizumab therapy is efficaciousin the treatment of patients with unresectable HCC,with significant improved QOL,which might be related to body immune modulation.

关 键 词：肝细胞癌 阿替利珠单抗 射频消融术 治疗 

分 类 号：R735.7[医药卫生—肿瘤]