实用肝脏病杂志 ›› 2025, Vol. 28 ›› Issue (6): 898-901.doi: 10.3969/j.issn.1672-5069.2025.06.025

• 肝癌 • 上一篇    下一篇

TACE联合免疫和靶向综合治疗中晚期原发性肝癌患者临床效果研究*

田潭平, 杨定华, 宋新, 周旅, 周国超, 付华, 蔡融民, 彭鹏   

  1. 416000 湖南省吉首市 吉首大学第一附属医院/湘西自治州人民医院肝胆外科
  • 收稿日期:2025-05-20 出版日期:2025-11-10 发布日期:2025-11-13
  • 通讯作者: 杨定华,E-mail:13974382020@139.com
  • 作者简介:田潭平,男,35岁,医学硕士,主治医师。E-mail:15074319864@163.com
  • 基金资助:
    *湖南省创新性建设项目(编号:2024JJ7555)

Local TACE with combination of immune and targeted therapy in the treatment of patients with advanced primary liver cancer

Tian Tanping, Yang Dinghua, Song Xin, et al   

  1. Department of Hepatobiliary Surgery, Xiangxi Autonomous Prefecture People's Hospital Affiliated to Jishou University, Jishou 416000, Hunan Province, China
  • Received:2025-05-20 Online:2025-11-10 Published:2025-11-13

摘要: 目的 探讨经导管肝动脉化疗栓塞术(TACE)联合免疫和靶向综合治疗中晚期原发性肝癌(PLC)的临床疗效。方法 2021年1月~2025年1月湖南省湘西自治州人民医院(吉首大学第一附属医院)肝胆外科收治的86例中晚期PLC患者,被分为对照组42例,行TACE治疗,和观察组44例,在TACE治疗的基础上联合仑伐替尼和替雷利珠单抗治疗。采用化学发光免疫分析法检测血清甲胎蛋白(AFP)和异常凝血酶原-II(PIVKA-Ⅱ)水平,使用流式细胞仪检测外周血淋巴细胞亚群。结果 在治疗3个月后,观察组疾病控制率(DCR)为70.5%,客观缓解率(ORR)为36.4%,均显著高于对照组的47.6%和16.7%(P<0.05);观察组血清AFP和PIVKA-Ⅱ水平分别为(653.5±131.5)ng/mL和(864.5±89.6)ng/mL,均显著低于对照组【分别为(965.5±152.2)ng/mL和(1038.4±91.3)ng/mL,P<0.05】;观察组外周血CD+4细胞百分比和CD+4/CD+8细胞比值分别为(33.6±3.1) %和(1.2±0.3),均显著高于对照组【分别为(29.5±2.7 %)和(0.9±0.2),P<0.05】;治疗后,观察组成功转化手术切除肿瘤8例(22.7%),而对照组只有3例(7.1%,P>0.05)。结论 对于中晚期PLC患者行局部TACE联合免疫和靶向治疗可提高短期疗效,可能与控制肿瘤生长和增强了机体免疫功能有关。

关键词: 原发性肝癌, 经肝动脉化疗栓塞术, 仑伐替尼, 替雷利珠单抗, 治疗

Abstract: Objective The aim of this study was to investigate efficacy of local transhepatic arterial chemoembolization (TACE) with combination of immune and targeted therapy in the treatment of patients with advanced primary liver cancer(aPLC). Methods 86 patients with aPLC were encountered in Department of Hepatobiliary Surgery, Xiangxi Autonomous Prefecture People's Hospital affiliated to Jishou University between January 2021 and January 2025, and assigned to undergo TACE in 42 cases in the control, or to receive TACE with combination of lenvatinib and tislelizumab treatment in another 44 cases in the observation for three months. Serum alpha-fetoprotein (AFP) and abnormal prothrombin-II (PIVKA-II) levels were detected routinely, and peripheral blood lymphocyte subsets were determined by FCM. Results By end of three-month treatment, the disease control rate was 70.5% and the objective remission rate was 36.4% in the observation group, both much higher than 47.6% and 16.7% (P<0.05) in the control group; serum AFP and PIVKA-Ⅱ levels were (653.5±131.5)ng/mL and (864.5±89.6)ng/mL, both much lower than [(965.5±152.2)ng/mL and (1038.4±91.3)ng/mL, respectively, P<0.05] in the control; percentage of peripheral blood CD+4 cells and CD+4/CD+8 cell ratio were (33.6±3.1) % and (1.2±0.3), both significantly higher than [(29.5±2.7 %) and (0.9±0.2), respectively, P<0.05] in the control; after treatment, the successful conversion surgery rate in the observation group was 22.7%, not significantly different as compared to 7.1% (P>0.05) in the control group. Conclusion Local TACE in combination with immune and targeted therapy in dealing with patients with aPLC is short-termly efficacious, which might alleviate immune suppression with control of tumor progression.

Key words: Hepatoma, Transhepatic arterial chemoembolization, Lenvatinib, Tislelizumab, Therapy