MWA联合抗PD-1抗体治疗原发性肝癌患者疗效研究*

doi:10.3969/j.issn.1672-5069.2024.02.025

摘要/Abstract

摘要： 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1 a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。

关键词: 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

Abstract: 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.

Key words: Hepatoma, Microwave ablation, Programmed death receptor-1, Therapy

付彦爽, 陈晓丽, 付彦青, 冯静. MWA联合抗PD-1抗体治疗原发性肝癌患者疗效研究^*[J]. 实用肝脏病杂志, 2024, 27(2): 259-262.

Fu Yanshuang, Chen Xiaoli, Fu Yanqing, et al.. Efficacy of microwave ablation and anti-PD-1 antibody therapy in patients with primary liver cancer[J]. Journal of Practical Hepatology, 2024, 27(2): 259-262.

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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^*

Efficacy of microwave ablation and anti-PD-1 antibody therapy in patients with primary liver cancer

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