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