信迪利单抗联合抗血管内皮生长因子单抗治疗不可手术切除的肝细胞癌患者临床疗效研究*

doi:10.3969/j.issn.1672-5069.2025.05.031

摘要/Abstract

摘要： 目的探讨信迪利单抗联合抗血管内皮生长因子(VEGF)单抗治疗不可手术切除的肝细胞癌(HCC)患者的疗效。方法 2022年1月～2024年1月我院收治的不可手术切除的HCC患者90例,被随机分为对照组45例和观察组45例,分别给予信迪利单抗或在此基础上联合抗VEGF单抗治疗4～6个疗程。应用SF-36健康调查简表评估生活质量,采用化学发光免疫分析仪检测血清VEGF、甲胎蛋白(AFP)和糖类抗原19-9(CA19-9)水平,使用流式细胞仪检测外周血淋巴细胞亚群。结果观察组客观缓解率和疾病控制率分别为28.9%和77.8%,均显著高于对照组的8.9%和55.6%(P＜0.05);治疗后观察组角色限制、生理功能、躯体功能和总体健康评分分别为(47.1±4.5)分、(43.5±5.3)分、(47.9±4.1)分和(55.8±5.7)分,均显著大于对照组【分别为(42.5±5.6)分、(38.7±3.7)分、(43.7±3.8)分和(48.0±5.3)分,P＜0.05】;观察组血清VEGF和AFP水平分别为(114.3±18.7)pg/ml和(73.4±8.6)μg/L,均显著低于对照组【分别为(132.8±17.6)pg/ml和(158.0±9.2)μg/L,P＜0.05】;观察组外周血CD⁺₃、CD⁺₄细胞百分比和CD₄/CD₈细胞比值分别为(41.7±4.9)%、(30.0±3.5)%和(1.6±0.2),均显著高于对照组【分别为(38.2±4.0)%、⁺(27.1±3.6)%和(1.4±0.2),P＜0.05】。结论信迪利单抗联合抗VEGF单抗治疗不可手术切除的HCC患者可获得一定的短期疗效,可能与提高了机体免疫功能和抑制了肿瘤血管生成有关。

关键词: 肝细胞癌, 信迪利单抗, 抗血管内皮生长因子单抗, 治疗

Abstract: Objective The aim of this study was to investigate clinical efficacy of sintilimaband anti-vascular endothelial growth factor (VEGF) antibody in the treatment of patients with unresectable hepatocellular carcinoma(HCC). Methods 90 patients with unresectable HCC were encountered in our hospital between January 2022 and January 2024, and were randomly divided into control group (n=45) and observation group (n=45), receiving sintilimab alone or combination of sintilimab with anti-VEGF antibody treatment for four to six regimen. SF-36 questionnaire was applied to assess life quality. Serum VEGF, alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) levels were detected routinely. Peripheral blood lymphocyte subsets were determined by FCM. Results Objective remission rate and disease control rate in the observation group were 28.9% and 77.8%, both much higher than 8.9% and 55.6%(P＜0.05) in the control; after treatment, role limitation, physiological function, physical function and overall health scores in the observation were (47.1±4.5)points, (43.5±5.3)points, (47.9±4.1)points and (55.8±5.7)points, all significantly greater than [(42.5±5.6)points, (38.7±3.7)points, (43.7±3.8)points and (48.0±5.3)points, respectively, P＜0.05] in the control; serum VEGF and AFP levels were (114.3±18.7)pg/ml and (73.4±8.6)μg/L, both significantly lower than [(132.8±17.6)pg/ml and (158.0±9.2)μg/L, respectively, P＜0.05] in the control group; percentages of peripheral blood CD⁺₃ and CD⁺₄ cells, and CD₄/CD₈ cell ratio were (41.7±4.9)%, (30.0±3.5)% and (1.6±0.2), all much higher than [(38.2±4.0)%, ⁺(27.1±3.6)% and (1.4±0.2), respectively, P＜0.05] in the control group. Conclusion The short-term efficacy of sintilimab plus anti-VEGF antibody combination is relatively satisfactory, which might be related to transiently improvement of body immune functions and inhibition of vascular formation of tumors.

Key words: Hepatoma, Sintilimab, Anti-vascular endothelial growth factor antibody, Therapy

徐嘉, 彭炜惟, 尹娜, 杨雨婷. 信迪利单抗联合抗血管内皮生长因子单抗治疗不可手术切除的肝细胞癌患者临床疗效研究^*[J]. 实用肝脏病杂志, 2025, 28(5): 763-766.

Xu Jia, Peng Weiwei, Yin Na, et al. Clinical observation of sintilimab and anti-vascular endothelial growth factor antibody in the treatment of patients with unresectable hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2025, 28(5): 763-766.

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信迪利单抗联合抗血管内皮生长因子单抗治疗不可手术切除的肝细胞癌患者临床疗效研究^*

Clinical observation of sintilimab and anti-vascular endothelial growth factor antibody in the treatment of patients with unresectable hepatocellular carcinoma

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