TACE联合索拉非尼及特瑞普利治疗中晚期原发性肝癌的效果

Efficacy of TACE Combined with Sorafenib and Triripril in the Treatment of Advanced Primary Liver Cancer

目的:观察肝动脉化疗栓塞术(TACE)联合索拉非尼及特瑞普利单抗治疗Ⅲa期以上原发性肝癌(PHC)的中远期疗效。方法:选取60例Ⅲa期以上(PHC)患者,采用随机数字表法将其分为对照组、观察组各30例;对照组行TACE联合索拉非尼治疗,观察组在对照组基础上增用特瑞普利单抗治疗;比较2组治疗总有效率、治疗前后细胞免疫功能、不良反应、中远期生存情况。结果:观察组临床总有效率83.34%高于对照组60.00%(P<0.05);治疗后观察组、对照组CD4^(+)T淋巴细胞占比、CD4^(+)/CD8^(+)均升高,且观察组[(40.17±5.92)%vs(35.60±6.01)%、(1.74±0.23)vs(1.37±0.19)]高于对照组(P<0.05),CD8^(+)T淋巴细胞占比均降低,观察组低于对照组[(23.15±2.93)%vs(26.06±3.22)%,P<0.05];Log-rank检验显示,2组6个月生存率比较,差异无统计学意义(P>0.05);观察组12、18个月生存率(82.14%vs 66.67%、67.86%vs 51.85%)均高于对照组(P<0.05);经Kaplan-Meier法分析,2组生存曲线差异有统计学意义(P<0.05)。结论:TACE术联合索拉非尼及特瑞普利单抗可提升Ⅲa期以上PHC患者近期、中远期疗效,改善细胞免疫,且安全可靠。

Objective:To observe the efficacy of transcatheter arterial chemoembolization(TACE)combined with sorafenib and treprizumab in the treatment of stageⅢa and above primary hepatic carcinoma(PHC).Methods:A total of 60 patients with stageⅢa and above PHC were selected and divided into a control group and a study group by random number table method,with 30 cases in each group.The control group was treated with TACE combined with sorafenib,and the study group was treated with treprizumab based on the control group.The total effective rate of treatment,cellular immune function before and after treatment,adverse reactions,and long-term survival were compared between the two groups.Results:The total clinical effective rate of the study group was higher than that of the control group(P<0.05).The proportion of CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)in the study group and the control group were increased,which of the study group were higher than those of the control group(P<0.05).The proportion of CD8^(+)T lymphocytes in the study group and the control group were decreased,which of the study group was lower than that of the control group(P<0.05).There were no significant differences in the incidence of adverse reactions between the two groups of changes in electrocardiogram,respiratory system,digestive system,blood system,abnormal thyroid function,endocrine metabolism,and renal function changes(P>0.05).Log-rank test showed that the 6-month survival rate of the two groups was not statistically different(P>0.05).The 12-and 18-month survival rate of the study group were higher than those of the control group(P<0.05).Kaplan-Meier method showed that the difference in survival curves between the two groups was statistically significant(P<0.05).Conclusion:TACE combined with sorafenib and treprizumab can enhance the short-term,mid-and long-term curative effect of PHC patients above stageⅢa,improve cellular immunity,and is safe and reliable.