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MWA联合抗PD-1抗体治疗原发性肝癌患者疗效研究

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目的 探讨微波消融(MWA)联合抗细胞程序性死亡受体-1(PD-1)抗体治疗原发性肝癌(PLC)患者的疗效。方法 2019 年6 月~2020 年12 月我院收治的PLC患者102 例,被分为对照组51 例和观察组51 例,分别接受MWA治疗或在MWA治疗的基础上应用信迪利单抗治疗6 个月。采用SF-36 量表评估生活质量,使用流式细胞仪检测外周血淋巴细胞亚群。随访1 年。结果 观察组客观有效率(ORR)为51。0%,显著高于对照组的29。4%(P<0。05);治疗后,观察组身体机能、生理职能、躯体疼痛、总体健康、精力、社会功能、角色限制和精神健康评分显著高于对照组(P<0。05);观察组外周血CD4+细胞百分比和CD4+/CD8+比值显著高于对照组(P<0。05),而CD4+CD25+FOXP3+Treg细胞和CD8+细胞百分比显著低于对照组(P<0。05);经Kaplan-Meier分析,观察组中位无进展生存率为9。7(95%CI:7。971~11。429)个月,对照组为7。8(95%CI:5。931~9。729)个月,观察组1a生存率为58。8%,显著高于对照组的37。3%(P<0。05)。结论 在MWA治疗的基础上联合抗PD-1 抗体治疗PLC患者能提高疗效,可能与纠正了免疫功能紊乱有关。
Efficacy of microwave ablation and anti-PD-1 antibody therapy in patients with primary liver cancer
Objective The purpose of this study was to investigate the efficacy of microwave ablation(MWA)and anti-programmed death receptor-1(PD-1)antibody therapy in patients with primary liver cancer(PLC).Methods A total of 102 patients with PLC were encountered in our hospital between June 2019 and December 2020,and were randomly divided into control(n=51)and observation group(n=51),receiving MWA or sintilimab immediately after MWA for six months.The quality of life was evaluated by 36-item shot-form health status survey(SF-36).The peripheral blood lymphocyte subsets was analyzed by FCM.All patients after therapy was followed-up for one year.Results The objective remission rate(ORR)in the observation group was much higher than in the control group(51.%vs.29.4%,P<0.05);at the end of six-month therapy,the physical function,physiological role,body pain,overall health,energy,social function,role limitation and mental health scores in the observation were significantly higher than in the control(P<0.05);the percentage of peripheral blood CD4+ cells and the CD4+/CD8+ cell ratio in the observation were much higher than in the control(P<0.05),while the percentage of CD4+CD25+FOXP3+ Treg cells and CD8+ cells were much lower than in the control(P<0.05);the Kaplan-Meier analysis showed that the median progression-free survival(PFS)in the observation group was 9.7(95%CI:7.971-11.429)mon,much longer than 7.8(95%CI:5.931-9.729)mon,and the one-year survival rate was 58.8%,also much higher than 37.3%(P<0.05)in the control group.Conclusion The administration of sintilimab immediately after MWA in treatment of patients with PLC is efficacious,which might be related to modulation of disturbed immune functions.

HepatomaMicrowave ablationProgrammed death receptor-1Therapy

付彦爽、陈晓丽、付彦青、冯静

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053000 河北省衡水市第三人民医院内二科

053000 河北省衡水市第三人民医院消化二科

衡水市第六人民医院内一科

华北理工大学附属医院内科

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原发性肝癌 微波消融 细胞程序性死亡受体-1免疫抑制剂 治疗

河北省卫健委医学科学研究计划项目

20221500

2024

实用肝脏病杂志
中华医学会安徽分会

实用肝脏病杂志

CSTPCD
影响因子:1.362
ISSN:1672-5069
年,卷(期):2024.27(2)
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