卡瑞利珠单抗辅助肝动脉化疗栓塞术治疗原发性肝癌的疗效及对T淋巴细胞亚群、肿瘤标志物水平的影响

Efficacy of carrellizumab combined with hepatic arterial chemoembolization in the treatment of primary liver cancer and its effect on T lymphocyte subsets,tumor markers levels

目的探讨卡瑞利珠单抗辅助肝动脉化疗栓塞术(TACE)治疗原发性肝癌(PLC)的疗效及其对T淋巴细胞亚群、肿瘤标志物水平的影响。方法选取2020年1月至2022年5月平煤神马医疗集团总医院收治的中晚期PLC患者,采用随机数字表法分为对照组和观察组。对照组给予TACE治疗,观察组给予卡瑞利珠单抗辅助TACE治疗。比较两组近期疗效、治疗前后T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平、肿瘤标志物[细胞角蛋白19(CK19)、甲胎蛋白(AFP)]水平及不良反应发生率。结果共纳入86例中晚期PLC患者,对照组43例,观察组43例。观察组客观缓解率(ORR)、疾病控制率(DCR)分别为65.12%、93.02%,均高于对照组的41.86%、72.09%(P<0.05);治疗后1个月和3个月,观察组外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组(P<0.05);观察组治疗后1个月和3个月的血清CK19、AFP水平低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论卡瑞利珠单抗辅助TACE治疗中晚期PLC能明显改善近期疗效,其作用机制与改善T淋巴细胞亚群、下调血清CK19和AFP水平有关,且未明显增加不良反应。

Objective To investigate the efficacy of carrellizumab combined with hepatic arterial chemoembolization(TACE)in the treatment of primary liver cancer(PLC)and its effect on T lymphocyte subsets,tumor markers levels.Methods Middle-aged and advanced PLC patients admitted to the Pingmei Shenma Medical Group General Hospital from January 2020 to May 2022 were selected and divided into a control group and an observation group by random number table method.The control group was given TACE treatment,and the observation group was given carrilizumab combined with TACE treatment.The short-term efficacy,T lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)),tumor markers[cytokeratin 19(CK19),alphafetoprotein(AFP)],and adverse reactions were compared between the two groups.Results A total of 86 PLC patients were included,43 cases in the control group and 43 cases in the observation group.The objective response rate(ORR)and disease control rate(DCR)in observation group were 65.12%and 93.02%,respectively,which was higher than 41.86%and 72.09%in the control group(P<0.05).At 1 month and 3 months after treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in peripheral blood of the observation group were higher than those of the control group(P<0.05).Serum CK19 and AFP levels in the observation group were lower than those in the control group at 1 month and 3 months after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Carrellizumab combined with TACE in the treatment of middle and late PLC can significantly improve the short-term efficacy,and its mechanism of action is related to the improvement of T lymphocyte subsets,the downregulation of serum CK19 and AFP levels without increased incidence of adverse reactions.