摘要
目的 探讨卡瑞利珠单抗联合经肝动脉化疗栓塞(TACE)治疗晚期原发性肝癌的临床效果及其对血清T淋巴细胞、甲胎蛋白异质体-L3(AFP-L3)等的影响.方法 前瞻性选取2019年8月至2022年12月在安徽医科大学附属宿州医院治疗的晚期HCC患者108例,按照信封法将患者分为观察组(n=54)和对照组(n=54).观察组给予卡瑞利珠单抗联合TACE治疗,对照组给予TACE治疗,观察两组治疗疗效、治疗前后血清T淋巴细胞、AFP-L3、甲胎蛋白(AFP),以及不良反应、无进展生存时间和总生存时间.结果 观察组治疗后3个月客观缓解率(ORR)和疾病控制率(DCR)分别为44.44％和88.89％,均明显高于对照组(25.93％、72.22％),差异均有统计学意义(P＜0.05).观察组治疗后3个月CD3+和CD4+T淋巴细胞分别为(68.82±6.40)％和(41.22±5.53)％,均明显高于对照组[(62.24±6.15)％、(37.73±6.00)％],而 CD8+T 淋巴细胞为(25.53±2.43)％,明显低于对照组[(27.05±2.28)％],差异均有统计学意义(P＜0.05).观察组治疗后3个月AFP-L3、AFP水平分别为(63.34±15.52)、(11.54±3.32)ng/mL,均明显低于对照组[(30.11±5.00)、(110.20±23.34)ng/mL],差异均有统计学意义(P＜0.05).观察组和对照组不良反应发生率比较差异均无统计学意义(P＞0.05).观察组无进展生存时间和总生存时间分别为8个月(95％CI:7.284～8.726)和15个月(95％CI:14.511～15.489),明显长于对照组(P＜0.05).结论 卡瑞利珠单抗联合TACE治疗晚期HCC有较好的效果,明显改善患者免疫功能,降低血清AFP-L3等指标水平,延长患者生存期.
Abstract
Objective To explore the clinical efficacy of combination therapy with Carolizumab and transcatheter arterial chemoemboliza-tion(TACE)in the treatment of advanced hepatocellular carcinoma(HCC),as well as its impact on serum T lymphocytes and alpha fetoprotein heterologous L3(AFP-L3).Methods A total of 108 patients with advanced primary liver cancer who were treated in Anhui Medical University Affiliated Suzhou Hospital from August 2019 to December 2022 were prospectively selected and divided into the observation group(n=54)and the control group(n=54)according to the envelope method.The observation group was treated with combination therapy of Carelizumab and TA-CE,while the control group was treated with TACE.The therapeutic efficacy,serum T lymphocytes,AFP-L3,alpha fetoprotein(AFP)before and after treatment,and adverse reactions,progression free survival time,and total survival time were observed in the two groups.Results The objective response rate(ORR)and disease control rate(DCR)of the observation group at 3 months after treatment were 44.44％and 88.89％,respectively,which were significantly higher than those of the control group(25.93％,72.22％),the differences were statistically significant(P＜0.05).At 3 months after treatment,the CD3+and CD4+T lymphocytes in the observation group were(68.82±6.40)％and(41.22±5.53)％,respectively,which were significantly higher than those in the control group[(62.24±6.15)％,(37.73±6.00)％],while the CD8+T lym-phocytes was(25.53±2.43)％,which was significantly lower than that in the control group[(27.05±2.28)％],the differences were statisti-cally significant(P＜0.05).At 3 months after treatment,the levels of AFP-L3,AFP in the observation group were(63.34±15.52),(11.54±3.32)ng/mL,respectively,which were significantly lower than those in the control group[(30.11±5.00),(110.20±23.34)ng/mL],the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group(P＞0.05).The progression free survival time and total survival time in the observation group were 8 months(95％CI:7.284-8.726)and 15 months(95％CI:4.511-15.489),respectively,which were significantly longer than those in the control group(P＜0.05).Conclusion Karelizumab combined with TACE has a good effect on the treatment of advanced HCC,significantly improving the patient's immune function,reducing serum levels of AFP-L3 and other indicators,and prolonging the patient's survival period.
基金项目
广西医科大学附属肿瘤医院青年科学基金资助项目(2021-06)
NETL
NSTL
万方数据