替雷利珠治疗晚期肝癌临床疗效及对PRMT5和PIVKA-II水平的影响

摘要/Abstract

摘要： 目的探讨替雷利珠对晚期肝癌患者蛋白质精氨酸甲基转移酶5(protein arginine methyl transferase 5, PRMT5)和维生素K缺乏或拮抗剂Ⅱ诱导蛋白(vitamin K absenceor antagonist-II, PIVKA-II)水平及预后的影响。方法选取襄阳市中心医院收治的晚期肝癌患者68例,随机分为观察组和对照组,每组34例。对照组给予经导管动脉栓塞化疗(transcatheter arterial chemoembolization, TACE),观察组在此基础上增加替雷利珠单抗治疗。比较两组治疗前后肝功能、T淋巴细胞水平、血管生成相关因子[酸性成纤维细胞生长因子(acid fibroblast growth factor, aFGF)、碱性成纤维细胞生长因子(basic fibroblast growth factor, bFGF)、血管内皮生长因子(vascular endothelial growth factor, VEGF)]水平、PRMT5 mRNA、PIVKA-II水平、癌症治疗功能总体评价量表(functional global assessment of cancer therapy, FACT-G)评分、近期疗效及远期预后。并记录两组治疗期间不良反应发生情况。结果治疗后,相较于对照组,观察组ALT、TBil、aFGF、bFGF、VEGF、PRMT5 mRNA、PIVKA-II水平及FACT-G评分更低,而Alb、CD3⁺、CD4⁺ T淋巴细胞、CD8⁺ T淋巴细胞、CD4⁺/CD8⁺水平更高(P<0.05);观察组客观缓解率、临床控制率、累积生存期及累积生存率分别为47.06%、76.47%、20.46(19.07,21.84)个月、52.94%,对照组分别为20.59%、52.94%、18.04(16.42,19.65)个月、35.29%,差异均有统计学意义(P<0.05);观察组和对照组治疗期间不良反应发生率分别为23.53%、32.35%,差异无统计学意义(P>0.05)。结论替雷利珠治疗晚期肝癌具有较好的临床效果,可改善患者免疫功能、血管生成及PRMT5和PIVKA-II水平。

关键词: 替雷利珠, 肝癌, 晚期, 蛋白质精氨酸甲基转移酶, 异常凝血酶原

Abstract: Objective To investigate the effects of Tirelizol on protein arginine methyltransferase-5(PRMT5) and PIVKA-II levels and the prognosis of patients with advanced liver cancer.Methods Sixty-eight patients with advanced liver cancer were selected as research objects. They were randomly divided into an observation group and a control group. The control group was treated with Trans-arterial chemo-embolization (TACE), and the observation group was treated with tirellizumab. The levels of liver function paremeters such as alanine aminotransferase (ALT), albumin (ALB), total bilirubin (TBIL), T lymphocytes (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺), angiogenic factors including acidic and basic fibroblast growth factors (bFGF, aFGF) and vascular endothelial growth factor (VEGF), and the level of PRMT5 mRNA were compared between the two groups before and after treatment. The vitamin K absence or antagonist-II (PIVKA-II) level, the Functional Assessment of Cancer Therapy-General (FACT-G) scores, short-term efficacy and long-term prognosis were also recorded in the two groups.Results After treatment, compared with the control group, ALT, TBil, aFGF, bFGF, VEGF, PRMT5 mRNA, PIVKA-II and FACT-G scores in the observation group were lower, whereas the Alb, CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ levels were higher (P<0.05). In the observation group, the Objective response rate, clinical control rate, cumulative survival time and cumulative survival rate were 47.06%, 76.47%, 20.46 (19.07, 21.84) months and 52.94%, and those of the control group were 20.59%, 52.94%, 18.04 (16.42, 19.65) months and 35.29%, the differences were statistically significant (P<0.05). The incidence of adverse reactions in the observation group and the control group was 23.53% vs 32.35%, respectively, without statistical significance (P>0.05).Conclusion Tirelizol has a good clinical effect on treating advanced liver cancer, and may improve the immune function, angiogenesis, PRMT5 and PIVKA-II levels.

Key words: Tirelizol, Liver cancer, Late stage, Protein arginine methyltransferase, Abnormal prothrombin

叶海辉, 江华. 替雷利珠治疗晚期肝癌临床疗效及对PRMT5和PIVKA-II水平的影响[J]. 肝脏, 2023, 28(12): 1435-1439.

YE Hai-hui, JIANG Hua. The clinical efficacy of Tirelizol on the treatment of advanced liver cancer and its influence on peripheral PRMT5 and PIVKA-II levels[J]. Chinese Hepatolgy, 2023, 28(12): 1435-1439.

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