超声引导下微波消融联合卡瑞利珠单抗治疗中晚期原发性肝癌的疗效观察

摘要/Abstract

摘要： 目的观察超声引导下微波消融联合卡瑞利珠单抗治疗中晚期原发性肝癌(PLC)的疗效。方法选取黄石市妇幼保健院2020年3月—2022年2月就诊的中晚期PLC患者97例,根据治疗方法不同分为对照组(48例)、观察组(49例)。对照组接受超声引导下微波消融治疗,观察组在对照组的基础上接受卡瑞利珠单抗治疗。对比2组免疫功能、肿瘤标志物水平[异常凝血酶原(DCP)、甲胎蛋白异质体(AFP-L3)、糖类抗原199(CA199)、癌胚抗原(CEA)]、临床疗效[疾病控制率(DCR)与客观缓解率(ORR)]与不良反应,随访1年,记录2组总生存情况。结果观察组治疗后的免疫球蛋白A(IgA)、IgM、IgG水平分别为(2.75±0.52)g/L、(18.74±3.24)g/L和(48.79±6.51)g/L,显著高于对照组[分别为(1.31±0.24)g/L、(8.45±1.62)g/L和(26.79±4.20)g/L,P<0.05];观察组治疗后的AFP-L3、DCP、CA199、CEA水平分别为(177.81±36.47)ng/mL、(26.15±3.24)mAU/mL、(50.28±4.03)ng/L和(8.79±1.65)ng/mL,显著低于对照组[分别为(287.39±56.21)ng/mL、(35.27±4.82)mAU/mL、(72.34±5.16)ng/L和(26.37±3.20)ng/mL,P<0.05];观察组DCR、ORR均比对照组高(P<0.05);随访1年,观察组和对照组生存率分别为79.17%(38/48)和55.32%(26/47)。结论超声引导下微波消融联合卡瑞利珠单抗可改善中晚期PLC患者免疫功能,降低血清肿瘤标志物水平,疗效显著,且可提高患者生存率。

关键词: 原发性肝癌, 微波消融, 卡瑞利珠单抗, 临床疗效, 预后

Abstract: Objective To observe the therapeutic efficacy of ultrasound-guided microwave ablation combined with camrelizumab for advanced primary liver cancer (PLC).Methods A total of 97 patients with middle and late stages of PLC were selected from March 2020 to February 2022.They were divided into a control group (48 cases) and an observation group (49 cases) according to different treatment methods. The control group received ultrasound-guided microwave ablation, and the observation group received additional carrilizumab treatment. The immune function, tumor marker levels [abnormal prothrombin (DCP), alpha-fetoprotein heteroplasmic (AFP-L3), carbohydrate antigen 199 (CA199), carcinoembryonic antigen (CEA)], clinical efficacy [disease control rate (DCR) and Objective response rate (ORR)] and adverse reactions were compared between the two groups. The overall survival of the two groups was recorded during 1-year follow-up.Results After treatment, serum immunoglobulin A (IgA), IgM and IgG levels in the observation group were (2.75±0.52) g/L, (18.74±3.24) g/L and (48.79±6.51) g/L, respectively, which were significantly higher than those of [(1.31±0.24) g/L, (8.45±1.62) g/L and (26.79±4.20) g/L in the control group (P<0.05). The levels of AFP-L3, DCP, CA199 and CEA in the observation group after treatment were (177.81±36.47) ng/mL, (26.15±3.24) mAU/mL, (50.28±4.03) ng/L, and (8.79±1.65) ng/mL, respectively, which was lower than those of [(287.39±56.21) ng/mL, (35.27±4.82) mAU/mL, (72.34±5.16) ng/L, and (26.37±3.20) ng/mL in the control group (P<0.05). The observation group demonstrated significantly higher DCR and ORR when compared to the control group (P<0.05). At 1-year follow-up, the observation group exhibited a survival rate of 79.17% (38/48), while the control group had a survival rate of 55.32% (26/47).Conclusion Ultrasound-guided microwave ablation combined with carrellizumab may improve immune function and reduce the levels of serum tumor markers in advanced PLC patients, and significantly improve their survival rate.

Key words: Primary liver cancer, Microwave ablation, Carrilizumab, Clinical effect, Prognosis

舒佳桔, 叶细容. 超声引导下微波消融联合卡瑞利珠单抗治疗中晚期原发性肝癌的疗效观察[J]. 肝脏, 2024, 29(12): 1493-1497.

SHU Jia-ju, YE Xi-rong. An observation study on the therapeutic efficacy of ultrasound-guided microwave ablation combined with camrelizumab for advanced primary liver cancer[J]. Chinese Hepatolgy, 2024, 29(12): 1493-1497.

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