信迪利联合靶向治疗中晚期原发性肝癌的临床研究

摘要/Abstract

摘要： 目的探究对原发性肝癌(PLC)中晚期患者予以信迪利联合靶向治疗的临床效果。方法 2019年9月—2023年6月阜南县人民医院及北区诊治的PLC患者84例,通过随机数字法均分为两组。对照组(42例)予以信迪利,观察组(42例)实施信迪利联合贝伐珠治疗。用药3个周期后,用酶联免疫吸附法测定血管生成及肿瘤相关血清指标,流式细胞仪测定免疫指标。Kapkan-Meier进行生存分析。结果治疗后,与对照组相比,观察组疾病控制率(76.19%vs92.86%)和客观缓解率(42.86%vs64.29%)较高,死亡率(47.62%vs23.81%)较低(P<0.05)。观察组CEA、AFP、CA19-9、DCP水平[分别为(16.7±3.3)ng/mL、(138.7±27.7)ng/mL、(142.7±20.3)U/mL、(30.5±4.3)mAU/mL]均显著低于对照组[分别为(21.4±4.2)ng/mL、(176.2±35.2)ng/mL、(165.6±23.6)U/mL、(35.2±5.1)mAU/mL](P<0.05)。观察组CD3⁺、CD4⁺/CD8⁺水平[分别为(72.9±4.8)%、(1.7±0.4)]均显著高于对照组[分别为(68.4±4.5)%、(1.4±0.3)](P<0.05)。观察组VEGF、MMP-9、Ang-2水平[分别为(22.5±4.3)ng/mL、(40.5±5.2)mg/L、(21.6±3.6)μg/L]均显著低于对照组[分别为(26.4±5.1)ng/mL、(44.6±5.5)mg/L、(25.1±4.2)μg/L](P<0.05)。结论信迪利联合贝伐珠单抗用于中晚期PLC疗效显著,患者肿瘤标志物及血管生成相关因子水平均下降,免疫功能及生存率均提高,且用药安全。

关键词: 原发性肝癌, 中晚期, 信迪利单抗, 贝伐珠单抗, 临床疗效

Abstract: Objective To explore the clinical effect of Sintilimab combined targeted therapy on intermediate and advanced primary liver cancer (PLC). Methods 84 patients with PLC treated from September 2019 to June 2023 at funan county people's hospital and the north district were involved and divided into two groups by random number method. The control group (42 cases) was treated with Sintilimab, and the observation group (42 cases) was treated with Sintilimab combined with bevacizumab. After 3 cycles of treatment, the levels of serum markers related to angiogenesis and tumor were measured by enzyme-linked immunosorbent assay, and the levels of immune markers were measured by flow cytometry. Kapkan-Meier curve was used for the survival analysis. Results After treatment, the disease control rate (64.29% vs 92.86%) and objective response rate (42.86% vs 76.19%) in the observation group were higher than those in the control group, and the mortality rate (23.81% vs 47.62%) was lower than that in the control group (P<0.05). The levels of CEA, AFP, CA19-9 and DCP in the observation group [(16.7±3.3) ng/mL, (138.7±27.7) ng/mL, (142.7±20.3) U/mL, (30.5±4.3) mAU/mL, respectively] were significantly lower than those in the control group [(21.4±4.2) ng/mL, (176.2±35.2) ng/mL, (165.6±23.6) U/mL, (35.2±5.1) mAU/mL, respectively] (P<0.05). The levels of CD3⁺ and CD4⁺/CD8⁺ in the observation group [(72.9±4.8) %, (1.7±0.4)] were significantly higher than those in the control group [(68.4±4.5) %, (1.4±0.3)] (P<0.05). The levels of VEGF, MMP-9 and Ang-2 in the observation group were [(22.5±4.3) ng/mL, (40.5±5.2) mg/L, (21.6±3.6) μg/L, respectively] were significantly lower than those in the control group [(26.4±5.1) ng/mL, (44.6±5.5) mg/L, (25.1± 4.2) μg/L] (P<0.05). Conclusion Sintilimab combined with bevacizumab is effective in the treatment of advanced PLC. The levels of tumor markers and angiogenesis-related factors are decreased, the immune function and survival rate are improved, and the drug is safe.

Key words: Primary liver cancer, Middle and late stage, Sindilimab, Bevacizumab, Clinical effect

董燕兵, 牛猛, 罗月宾, 闻听亮. 信迪利联合靶向治疗中晚期原发性肝癌的临床研究[J]. 肝脏, 2024, 29(9): 1068-1073.

DONG Yan-bing, NIU Meng, LUO Yue-bin, WEN Ting-liang. Clinical study of Sintilimab combined targeted therapy for intermediate and advanced primary liver cancer[J]. Chinese Hepatolgy, 2024, 29(9): 1068-1073.

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