TACE辅助免疫靶向治疗对晚期不可切除肝内胆管细胞癌的临床研究  

Clinical study of TACE assisted immunotargeted therapy for advanced unresectable intrahepatic cholangiocarcinoma

作　　者：彭茴茴 李媛[1] 孟德敏 PENG Huihui;LI Yuan;Meng Demin(Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学第一附属医院肝胆胰外科,河南郑州450000

出　　处：《中国医学工程》2025年第4期63-67,共5页China Medical Engineering

基　　金：河南省医学科技攻关项目(LHGJ202001341)。

摘　　要：目的观察肝动脉化疗栓塞术(TACE)辅助免疫靶向治疗晚期不可切除肝内胆管细胞癌的临床效果。方法选取郑州大学第一附属医院2021年1月至2023年2月收治的106例晚期不可切除肝内胆管细胞癌为研究对象,开展前瞻性随机、对照临床试验,基于计算机随机分组法将入组患者分别列为常规组和TACE组各53例,常规组实施常规免疫治疗及靶向治疗,TACE组采用TACE辅助免疫治疗及靶向治疗,两组治疗后均随访1年,比较两组患者的肿瘤标志物水平,免疫功能,近期疗效,短期生存情况。结果在不同治疗方案下,TACE组的癌胚抗原(CEA)、糖类抗原242(CA242)、糖类抗原199(CA199)分别为(20.33±5.28)ng/mL、(21.45±5.33)U/mL、(42.19±10.44)U/mL,均低于常规组[(23.39±5.34)ng/mL、(24.49±5.28)U/mL、(47.65±10.22)U/mL](P<0.05);TACE组的T淋巴细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)分别为(70.24±10.33)%、(71.25±10.45)%、(1.75±0.45),均高于常规组[(65.22±10.41)%、(66.39±10.27)%、(1.26±0.77)](P<0.05);TACE组的客观缓解率(ORR)、疾病控制率(DCR)分别为84.91%(45/53)、90.57%(48/53),均高于常规组[60.38%(32/53)、67.92%(36/53)](P<0.05);截止随访结束时,TACE1年内生存率、中位无进展生存期(PFS)、中位总生存期(OS)分别为86.79%(46/53)、(10.23±2.15)个月、(11.35±2.44)个月,均高于常规组[66.04%(35/53)、(9.27±1.52)个月、(10.34±2.15)个月](P<0.05)。TACE组的毒副反应发生率为28.30%(15/53),与常规组[24.53%(13/53)]比较差异无统计学意义(P>0.05)。结论TACE辅助免疫靶向治疗晚期不可切除肝内胆管细胞癌能增强抗肿瘤效果,并改善患者免疫功能,对提升近期疗效、改善短期预后均有积极意义。【Objective】To observe the clinical efficacy of TACE assisted immunotargeted therapy for advanced unresectable intrahepatic cholangiocarcinoma.【Methods】This article focused on 106 cases of advanced unresectable intrahepatic cholangiocarcinoma treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to February 2023.A prospective randomized controlled clinical trial was conducted,and the enrolled patients were divided into the conventional group(53 cases)and the TACE group(53 cases)based on computer random grouping method.The conventional group received conventional immunotherapy and targeted therapy,while the TACE group received TACE adjuvant immunotherapy and targeted therapy.Both groups were followed up for one year after treatment to compare their tumor marker levels,immune function,recent efficacy,and short-term survival.【Results】Under different treatment regimens,the CEA,CA242,and CA199 of the TACE group were 20.33±5.28 ng/mL,21.45±5.33 U/mL,and 42.19±10.44 U/mL,lower than the conventional group(23.39±5.34 ng/mL,24.49±5.28 U/mL,and 47.65±10.22 U/mL)(P<0.05).The CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)levels in the TACE group were 70.24%±10.33%,71.25%±10.45%,and 1.75±0.45,higher than the conventional group(65.22%±10.41%,66.39%±10.27%,and 1.26±0.77)(P<0.05).The objective response rate(ORR)and disease control rate(DCR)of the TACE group were 84.91%(45/53)and 90.57%(48/53),higher than the conventional group[60.38%(32/53)and 67.92%(36/53)](P<0.05).As of the end of follow-up,the one-year survival rate,median progression free survival(PFS),and median overall survival(OS)of TACE group were 86.79%(46/53),10.23±2.15 months,and 11.35±2.44 months,higher than the conventional group[66.04%(35/53),9.27±1.52 months,and 10.34±2.15 months](P<0.05).The incidence of chemotherapy related side effects in the TACE group was 28.30%(15/53),slightly higher than the conventional group[24.53%(13/53)](P>0.05).【Conclusion】TACE assisted immunotargeted therapy for advanced unresectable int

关 键 词：不可切除肝内胆管细胞癌 肝动脉化疗栓塞术 免疫治疗 靶向治疗 预后情况 

分 类 号：R735.7[医药卫生—肿瘤]