Abstract: Objective To observe the effects of ramucirumab combined with sorafenib on immune function, quality of life and survival status of patients with hepatocellular carcinoma (HCC), and evaluate the clinical efficacy and safety of the combined treatment regimen. Methods Eighty-six patients with HCC in our hospital from January 2017 to December 2018 were included as the study subjects. They were randomly divided into a monotherapy group (46 cases) and a combined treatment group (46 cases) by random number table method. Patients in the monotherapy group received oral administration of sorafenib, and patients in the combined treatment group received ramucirumab injection treatment. All patients were continually treated until disease progression or intolerance. The clinical efficacy, liver function index, T cell ratio, tumor marker level and quality of life were compared between the two groups before and after treatment. Results After treatment, the serum albumin (Alb) (41.87±8.96 vs 46.00±6.52), alanine aminotransferase (ALT) (105.42±26.08 vs 92.24±18.19), aspartate aminotransferase (AST) (108.63±24.32 vs 96.75±20.29) and total bilirubin (TBil) (61.07±6.11 vs 53.54±6.71) of combined treatment group patients were significantly lower than those of the monotherapy group patients (t=2.663, 3.940, 2.962, 5.929, all P<0.05). CD4⁺T (42.15±6.61 vs 36.24±6.15) and CD4⁺/CD8⁺ ratio (1.79±0.37 vs 1.45±0.39) were significantly higher than those in monotherapy group, while CD8⁺ T ratio (21.56±4.97 vs 26.58±4.59) was significantly lower (t=4.677, 5.299, 4.607, all P<0.05). The serum alpha fetoprotein (AFP) (52.96±13.80 vs 74.40±20.26) and carbohydrate antigen 242 (CA242) (36.72±9.94 vs 44.82±12.47) were significantly lower than those in the monotherapy group (t=6.245, 3.627, all P<0.05). Short-form 36 questionnaire (SF-36) score (62.78±6.59 vs 59.04±5.81) and objective response rate (ORR) (80.39% vs 60.78%) were significantly higher than those in the monotherapy group (t=3.043, χ²=4.722, all P<0.05). During the treatment, there was no significant difference in the incidence of adverse events between the two groups (9.80% vs 15.69%, P>0.05). Conclusion Ramucirumab combined with sorafenib can effectively improve immune function, reduce liver function injury degree and serum tumor markers in HCC patients, and has better clinical efficacy, which has important clinical application value for improving quality of life and prognosis of HCC patients.

Key words: ramucirumab, sorafenib, hepatocellular carcinoma, immune function, clinical efficacy