靶向治疗联合免疫治疗对晚期肝癌患者疾病控制情况及血清相关指标的影响

Effect of Targeted Therapy Combined with Immunotherapy on Disease Control and Serum Related Indicators in Patients with Advanced Liver Cancer

目的分析靶向治疗联合免疫治疗在晚期肝癌患者中的效果。方法选取2020年1月至2022年1月南昌大学第四附属医院收治的200例晚期肝癌患者,按随机数字表法分为两组,各100例。对照组给予卡瑞利珠单抗治疗,观察组加以阿帕替尼治疗,连续治疗2个月。对比两组临床疗效、免疫功能、肿瘤标志物、血管内皮生长因子(VEGF)水平及不良反应。结果观察组治疗总有效率为75.00%(75/100),高于对照组的62.00%(62/100)(P<0.05)。治疗前,两组CD3+、CD4+、CD8+、癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)、甲胎蛋白(AFP)、VEGF相比,差异无统计学意义(P>0.05);治疗后,观察组CD3+为(49.21±4.72)%、CD4+为(43.84±3.94)%,高于对照组的(42.59±4.03)%、(36.20±3.16)%,CD8+为(22.21±2.05)%、CEA为(20.21±2.78)ng/mL、CA125为(49.36±4.53)U/mL、CA199为(42.58±4.36)U/mL、AFP为(48.95±2.05)ng/mL、VEGF为(85.31±8.36)pg/mL,低于对照组的(28.65±2.48)%、(26.58±3.05)ng/mL、(63.47±5.21)U/mL、(50.21±6.25)U/mL、(56.27±2.63)ng/mL、(106.72±10.21)pg/mL;均差异有统计学意义(P<0.05)。两组不良反应相比,差异无统计学意义(P>0.05)。结论靶向治疗联合免疫治疗在晚期肝癌患者中效果显著,能够有效改善其免疫功能,杀灭机体肿瘤细胞,降低VEGF表达,且不良反应较少。

Objective To analyze the efficacy of targeted therapy combined with immunotherapy in patients with advanced liver cancer.Methods 200 patients with advanced liver cancer admitted to Fourth Affiliated Hospital of Nanchang University from January 2020 to January 2022 were randomly divided into two groups,with 100 patients in each group.The control group was treated with camrelizumab,while the observation group was treated with apatinib,all treated for 2 months.Clinical efficacy,immune function,tumor markers,vascular endothelial growth factor(VEGF)levels,and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 75.00%(75/100),higher than that in the control group 62.00%(62/100),with a statistically significant difference(P<0.05);before treatment,there was no statistically significant difference in CD3+,CD4+,CD8+,carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),alpha fetoprotein(AFP),and VEGF between the two groups(P>0.05);after treatment,the observation group had(49.21±4.72)%of CD3+,(43.84±3.94)%of CD4+,which was higher than the control group's(42.59±4.03)%,(36.20±3.16)%;(22.21±2.05)%of CD8+,(20.21±2.78)ng/mL of CEA,(49.36±4.53)U/mL of CA125,(42.58±4.36)U/mL of CA199,(48.95±2.05)ng/mL of AFP,and(85.31±8.36)pg/mL of VEGF,which were lower than the control group's(28.65±2.48)%,(26.58±3.05)ng/mL,(63.47±5.21)U/mL,(50.21±6.25)U/mL,(56.27±2.63)ng/mL,and(106.72±10.21)pg/mL,with statistical differences(P<0.05);there was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Targeted therapy combined with immunotherapy has a significant effect in patients with advanced liver cancer,which can effectively improve their immune function,kill tumor cells,reduce VEGF expression,and have fewer adverse reactions.