Objective To explore the clinical mechanism of PD-1 and VEGFR2 inhibitors combined in intervening the progression of colon cancer liver metastasis.Methods 120 patients with colon cancer liver metas-tasis from Feb.2021 to Dec.2022 were selected as research subjects.According to the treatment plan,patients were divided into control group(n=60)and observation group(n=60).The control group received PD-1 inhibitor treatment,while the observation group received combination of PD-1 inhibitor and VEGFR2 inhibitor treatment.Tumor vascular density and permeability were evaluated by dynamic contrast-enhanced magnetic resonance imag-ing(DCE-MRI).The expression of PD-1 and VEGFR2 proteins were analyzed through protein blot.The levels of serum inflammatory factors IFN-γ,TNF-α,and IL-12 in patients before and after intervention were detected us-ing ELISA.The tumor control effects between the two groups of patients were compared.The average overall surviv-al and average progression free survival between the two groups of patients were compared.Results Before inter-vention,there was no statistically significant difference in vascular permeability or density between the observation group and the control group patients;After 6 weeks of intervention,the vascular permeability and density of pa-tients in the observation group decreased compared to the control group.There were no significant changes in vas-cular permeability or density in the control group before and after intervention.Before intervention,there was no statistically significant difference in the expression of PD-1 or VEGFR2 proteins between the observation group and the control group;P＞0.05;After 6 weeks of intervention,the expression of PD-1 and VEGFR2 proteins in both groups of patients decreased compared to that before intervention.The expression of PD-1 and VEGFR2 proteins in the observation group decreased compared to that of the control group(PD-1:1.04±0.02 vs.1.30±0.04;VEGFR2:1.12±0.01 vs.1.57±0.16);P＜0.05.Before intervention,there was no statistically significant difference in serum lev-els of IFN-γ,TNF-α,or IL-12 between the observation group and the control group;After 6 weeks of interven-tion,the serum levels of IFN-γ,TNF-α,and IL-12 in both groups of patients increased compared to those before intervention.However,the observation group showed a more significant increase in IFN-γ,TNF-α,and IL-12 lev-els compared to the control group(IFN-γ:38.44±3.28 pg/mL vs.27.55±2.63 pg/mL;TNF-α:44.62±2.15 pg/mL vs.30.57±2.09 pg/mL);IL-12:33.49±2.51 pg/mL vs.20.75±1.86 pg/mL;P＜0.05).In the control group,there were 8 cases of partial tumor remission,14 cases of stable tumor phase,and 22 cases of effective tumor control.In the ob-servation group,there were 17 cases of partial tumor remission,24 cases of stable tumor phase,and 41 cases of ef-fective tumor control.PR,SD,and DCR in the observation group were higher than those in the control group,and the difference was statistically significant(P＜0.05).The average overall survival and mean progression free surviv-al of the observation group were longer than those of the control group.Conclusions Combined treatment with PD-1 and VEGFR2 inhibitors significantly improves tumor control and survival in patients with colon cancer liver me-tastases.By reducing tumor vessel density and permeability,enhancing immune responses,and reducing immune evasion of tumor cells,the combined intervention provides a more effective clinical strategy for the treatment of co-lon cancer liver metastases.
NETL
NSTL
万方数据
