目的

分析程序性死亡受体-1 抑制剂信迪利单抗联合多靶点受体酪氨酸激酶抑制剂仑伐替尼及经导管动脉化疗栓塞术（TACE）治疗中晚期肝癌患者的疗效及对细胞免疫功能的影响。

方法

选取2020 年6 月至2023 年6 月黄山市人民医院收治的100 例中晚期肝癌患者，使用简单随机抽样法分别纳入观察组（n=50）、对照组（n=50），2 组均接受信迪利单抗联合仑伐替尼治疗，观察组加用TACE。对比2 组近期疗效、治疗前后肿瘤标志物和细胞免疫功能变化、不良反应发生率，通过随访记录其1 年生存情况。

结果

治疗3 个月后，观察组客观缓解率、疾病控制率分别为42.00%、82.00%，均较对照组的20.00%、64.00%更高（P＜0.05）；2 组治疗后甲胎蛋白、异常凝血酶原、癌胚抗原、糖类抗原19-9 均较治疗前下降，观察组均较对照组更低（P＜0.05）；2 组治疗后CD₃⁺、CD₈⁺均较治疗前下降，CD₄⁺、CD₄⁺/CD₈⁺均较治疗前升高，观察组CD₃⁺、CD₈⁺均较对照组更低，CD₄⁺、CD₄⁺/CD₈⁺均对照组更高（P＜0.05）。2 组不良反应发生率比较，差异无统计学意义（P＞0.05）。治疗1 年后，观察组均较对照组平均无进展生存期[（10.17±2.08）比（8.04±1.75）个月]、总生存期[（18.83±3.19）比（15.34±2.29）个月]更长（P＜0.05）。

结论

在信迪利单抗联合仑伐替尼的基础上，将TACE 应用于中晚期肝癌患者的治疗能够取得更为理想的近期疗效，在不增加不良反应的同时改善患者肿瘤标志物和免疫功能，延长生存期。

Objective

To analyze the efficacy of programmed death receptor-1(PD-1) inhibitor cindilizumab combined with multi-target receptor tyrosine kinase inhibitor ranvartinib and transcatheter arterial chemoembolization (TACE) in the treatment of patients with advanced liver cancer and its influence on cellular immune function.

Methods

A total of 100 patients with advanced liver cancer in Huangshan People's Hospital from June 2020 to June 2023 were selected for a controlled study.The observation group (n=50) and the control group (n=50) were included respectively by simple random sampling method.Both groups were treated with cindilizumab combined with ranvartinib, and the observation group was added with TACE.The short-term curative effect, changes of tumor markers and cellular immune function before and after treatment, and the incidence of adverse reactions were compared between the two groups, and their 1-year survival was recorded through follow-up.

Results

After 3 months of treatment, the objective remission rate and disease control rate of the observation group were 42.00% and 82.00% respectively, which were higher than those of the control group (20.00% and 64.00%,respectively) (P<0.05).After 3 months of treatment, AFP, PIVKA-Ⅱ, CEA and CA19-9 in both groups decreased compared with those before treatment, and the levels in the observation group were all lower than those in the control group (P<0.05).After 3 months of treatment, CD3⁺ and CD8⁺ in both groups decreased, while CD4⁺ and CD4⁺/CD8⁺ increased.CD3⁺ and CD8⁺ in the observation group were lower than those in the control group, and CD4⁺ and CD4⁺/CD8⁺ were higher than those in the control group(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).The average progression free survival [(10.17±2.08) months vs.(8.04±1.75) months] and overall survival [(18.83±3.19) months vs.(15.34±2.29) months]of the observation group were longer than those of the control group (P<0.05).

Conclusion

On the basis of cindilizumab combined with ranvartinib, TACE can achieve better short-term efficacy in patients with advanced liver cancer, and can improve tumor markers and immune function without increasing adverse reactions, and prolong survival period.