微波消融联合信迪利单抗对中晚期肝细胞癌患者疾病控制效果、免疫功能及预后的影响

肝脏 ›› 2025, Vol. 30 ›› Issue (7): 934-937.

微波消融联合信迪利单抗对中晚期肝细胞癌患者疾病控制效果、免疫功能及预后的影响

李卉, 周义文, 王务军, 陈江波

242100 安徽宣城郎溪县人民医院药学部(李卉,周义文),重症医学科(王务军),肝胆、肛肠科(陈江波)

收稿日期:2025-01-12 出版日期:2025-07-31 发布日期:2025-08-11
通讯作者: 陈江波
基金资助:
宣城市2024继续医学教育项目(130407032)

The effect of microwave ablation combined with Sintilimab on disease control, immune function and prognosis of patients with advanced hepatocellular carcinoma

LI Hui¹, ZHOU Yi-wen¹, WANG Wu-jun², CHEN Jiang-bo³

1. Department of Pharmacy, Langxi County People′s Hospital, Xuancheng 242100, China;
2. Department of Intensive Care Medicine, Langxi County People′s Hospital, Xuancheng 242100, China;
3. Department of Hepatobiliary and Proctology, Langxi County People′s Hospital, Xuancheng 242100, China

Received:2025-01-12 Online:2025-07-31 Published:2025-08-11
Contact: CHEN Jiang-bo

摘要/Abstract

摘要： 目的分析微波消融(MWA)联合信迪利单抗对中晚期肝细胞癌(HCC)患者疾病控制效果、免疫功能及预后的影响。方法将2020年6月—2022年10月我院诊治的83例中晚期HCC 患者纳入研究,按照治疗方式分为联合组和MWA组。联合组采用MWA联合信迪利单抗治疗,MWA组仅予以MWA治疗,比较两组疾病控制效果、免疫功能及预后情况。结果联合组客观有效率(CR、PR之和占所有病例比例)为60.0%,显著高于MWA组(30.2%),P<0.05。治疗后,联合组各项生活质量评分均显著高于MWA组(P<0.05)。治疗后,联合组血清AFP、抑制性T细胞、CD4⁺、CD8⁺细胞、CD4⁺/CD8⁺比值及KPS评分为(92.4±22.9)ng/mL、(1.3±0.2)%、(33.1±6.9)%、(24.6±5.3)%、(1.4±0.5)及(87.4±7.0)分,均显著优于MWA组[(117.5±32.0)ng/mL、(1.5±0.3)%、(29.1±5.4)%、(27.1±5.0)%、(1.1±0.4)及(79.2±7.4)分,P<0.05]。联合组、MWA组失访2例、3例。联合组1年、2年生存率为94.7%(36/38)、76.3%(29/38),经Kaplan-Meier生存分析,分别显著高于MWA组[77.5%(31/40)、52.5%(21/40),P<0.05],显示联合组生存率显著高于MWA组(P<0.05)。结论 MWA联合信迪利单抗在局部控制、全身免疫调节及生存获益方面具有显著优势,未来应进一步推动其临床推广并优化研究。

关键词: 中晚期肝细胞癌, 微波消融, 信迪利单抗

Abstract: Objective To analyze the effect of microwave ablation (MWA) combined with Sintilimab on disease control, immune function and prognosis of patients with advanced hepatocellular carcinoma (HCC). Methods Between June 2020 and October 2022, eighty-three patients with advanced HCC were diagnosed and treated in people′s hospital of Langxi county. The combined group was treated with MWA combined with Sintilimab, while the MWA group was only treated with MWA. The effect of disease’ control, immune function and prognosis of the two groups of patients were compared. Results The combined treatment group achieved an objective response rate (ORR) of 60.0% (CR+PR) , which was significantly higher compared to that of 30.2% in the MWA group (P<0.05), along with superior post-treatment quality of life scores (P<0.05). Post-treatment laboratory results in the combined group showed significantly better outcomes for serum alpha-fetoprotein (AFP) (92.4±22.9 vs 117.5±32.0 ng/mL), Treg cells (1.3±0.2% vs 1.5±0.3%), CD4⁺ cells (33.1±6.9% vs 29.1±5.4%), CD8⁺ cells (24.6±5.3% vs 27.1±5.0%), CD4⁺/CD8⁺ ratio (1.4±0.5 vs 1.1±0.4), and Karnofsky (KPS) score (87.4±7.0 vs 79.2±7.4 points, all P<0.05). With 2 vs 3 cases lost to follow-up in the combined and MWA groups, respectively. Kaplan-Meier analysis revealed significantly higher survival rates in the combined group at both 1-year [94.7% (36/38) vs 77.5% (31/40)] and 2-year follow-up [76.3% (29/38) vs 52.5% (21/40), P<0.05]. Conclusion MWA combined with Sintilimab has obvious advantages in local control, systemic immune regulation and survival benefit, and its clinical promotion and optimization research should be further promoted in the future.

Key words: Advanced hepatocellular carcinoma, Microwave ablation, Sintilimab

李卉, 周义文, 王务军, 陈江波. 微波消融联合信迪利单抗对中晚期肝细胞癌患者疾病控制效果、免疫功能及预后的影响[J]. 肝脏, 2025, 30(7): 934-937.

LI Hui, ZHOU Yi-wen, WANG Wu-jun, CHEN Jiang-bo. The effect of microwave ablation combined with Sintilimab on disease control, immune function and prognosis of patients with advanced hepatocellular carcinoma[J]. Chinese Hepatolgy, 2025, 30(7): 934-937.

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