特瑞普利单抗联合TACE对巨块型肝癌治疗效果及Wnt1、β-catenin、DKK1的影响

摘要/Abstract

摘要： 目的探讨特瑞普利单抗联合肝动脉化疗栓塞术(TACE)对巨块型肝癌治疗效果及Wnt1蛋白(Wnt1)、β-连接蛋白(β-catenin)、分泌型蛋白Dickkopf1(DKK1)的影响。方法选取2020年5月至2022年10月在儋州市人民医院就诊的巨块型肝癌患者76例,根据随机数字表法分为观察组和对照组,各38例。对照组行TACE治疗,观察组在TACE术后1周开始给予特瑞普利单抗240 mg,3周给药1次。术后6周进行疗效评估。于治疗前、治疗6周分别检测甲胎蛋白(AFP)、血管内皮生长因子(VEGF)、Wnt1、β-catenin、DKK1,采用卡氏功能状态评分(KPS)评估生存质量变化情况。统计2组治疗期间不良反应发生率及肿瘤无进展生存时间(PFS)。结果观察组客观缓解率(ORR)为63.16%(24/38) 高于对照组的39.47%(15/38),差异有统计学意义 (χ²=4.266,P=0.039)。治疗6周2组AFP、VEGF、β-catenin、DKK1水平均降低,Wnt1水平升高,且观察组变化幅度大于对照组(P<0.05)。观察组生存质量改善30例(78.95%), 高于对照组的21例(55.26%),差异有统计学意义 (χ²=4.828,P=0.028);2组不良反应发生率比较,差异无统计学意义(P>0.05)。观察组PFS为6(2,8)个月,对照组为3(1,5)个月,差异有统计学意义(P<0.05)。结论特瑞普利单抗配合TACE对巨块型肝癌疗效确切,可调节AFP、VEGF水平,抑制Wnt信号通路,延长患者生存期,且安全性可控。

关键词: 特瑞普利单抗, 肝动脉化疗栓塞术, 巨块型肝癌, Wnt1蛋白, β-连接蛋白, 分泌型蛋白Dickkopf1

Abstract: Objective To investigate the effect of triplimab combined with hepatic arterial chemoembolization (TACE) on the treatment of massive liver cancer and the levels of Wnt1 protein (Wnt1), β-catenin and secreted protein Dickkopf1 (DKK1). Methods Seventy-six cases of massive liver cancer treated from May 2020 to October 2022 were selected and divided into an observation group and a control group according to random number table method with 38 cases in each group.The control group was treated with TACE, and the observation group was treated with 240mg of terriplizumab at 1 week after TACE, followed by once every 3 weeks. The efficacy was evaluated in 6 weeks after operation. Alpha-fetoprotein (AFP), vascular endothelial growth factor (VEGF), Wnt1, β-catenin and DKK1 were detected before treatment and 6 weeks after treatment. The change of quality of life was evaluated by KPS. The incidence of adverse reactions and progression-free survival time (PFS) during treatment were analyzed. Results The objective remission rate (ORR) of the observation group was higher than that of the control group (P<0.05). After 6 weeks of treatment, the levels of AFP, VEGF, β-catenin and DKK1 in both groups decreased, whereas the levels of Wnt1 increased, and the change range of the observation group was greater than that of the control group (P<0.05). The improvement of life quality in the observation group was higher than that in control group (P<0.05). There was no significant difference in the incidence of adverse reactions between these two groups (P>0.05).The PFS of the observation group was 6 (2,8) months, which was longer than that of 3 (1,5) months in the control group(P<0.05). Conclusion Triprilizumab combined with TACE has definite efficacy in the treatment of massive liver cancer, and it can regulate AFP and VEGF levels, inhibit Wnt signaling pathway, promote the patients’ quality of life, prolong the survival of patients, with controllable safety.

Key words: Triprimab, Hepatic arterial chemoembolization, Massive liver cancer, Wnt1 protein, β-connexin, Secretory protein Dickkopf1

张月馨, 郑文宏, 吴德建, 谭义炫, 周聪. 特瑞普利单抗联合TACE对巨块型肝癌治疗效果及Wnt1、β-catenin、DKK1的影响[J]. 肝脏, 2024, 29(11): 1352-1357.

ZHANG Yue-xin, ZHENG Wen-hong, WU De-jian, TAN Yi-xuan, ZHOU Cong. The effect of triplelizumab combined with TACE on the treatment of massive liver cancer and the levels of Wnt1, β-catenin and DKK1[J]. Chinese Hepatolgy, 2024, 29(11): 1352-1357.

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