仑伐替尼联合肝动脉化疗栓塞术对肝癌患者肿瘤标志物、免疫功能的影响

Effects of Lenvatinib Combined with TACE on Tumor Markers and Immune Function in Patients with Liver Cancer

目的分析仑伐替尼联合肝动脉化疗栓塞术(TACE)治疗肝癌的临床效果及对肿瘤标志物、免疫功能相关分子的影响。方法商丘市立医院2021年1月至2023年7月肝癌患者76例作为研究对象,以不同治疗方案分为对照组、联合组,各38例。对照组予以TACE治疗,联合组予以仑伐替尼联合TACE治疗。连续治疗2个月后,比较两组疗效,不良反应,生存情况,肿瘤标志物[甲胎蛋白(AFP)、糖类抗原199(CA199)、α-L-岩藻糖苷酶(AFU)、癌胚抗原(CEA)]及免疫分子[Toll样受体2(TLR 2)、TLR 4、髓样分化因子88(MyD 88)]。结果治疗2个月后联合组病情控制率(DCR)为78.95%,高于对照组57.89%(P<0.05),联合组客观缓解率(ORR)为42.11%,与对照组的26.32%相比,差异无统计学意义(P>0.05)。治疗2个月后,联合组AFP、CA199、AFU、CEA低于对照组(P<0.05);联合组TLR2、TLR4、MyD88低于对照组(P<0.05)。两组疼痛、疲乏、腹泻、血小板下降、高血压、蛋白尿、手足综合征等不良反应发生率相比,差异无统计学意义(P>0.05);联合组发热发生率(15.79%)低于对照组(36.84%)(P<0.05);联合组中位总生存时间(OS)、中位无进展生存(PFS)高于对照组(P<0.05)。结论仑伐替尼联合TACE治疗肝癌疗效确切,能改善免疫功能紊乱及肿瘤标志物水平,提高ORR,增加OS、PFS,且不良反应可控。

Objective To analyze the clinical effects of lenvatinib combined with transcatheter arterial chemoembolization(TACE)in the treatment of liver cancer and its effects on tumor markers and immune function related molecules.Methods 76 cases of liver cancer patients in Shangqiu Municipal Hospital from January 2021 to July 2023 were retrospectively studied and divided into control group and combination group with 38 cases each according to different treatment regiments.The control group was treated with TACE,and the combination group was treated with lenvatinib combined with TACE.Two months after treatment,the efficacy,adverse reactions,survival,tumor markers[alpha-fetoprotein(AFP),carbohydrate antigen 199(CA199),α-L-fucosidase(AFU),carcinoembryonic antigen(CEA)]and immune molecules[Toll-like receptor 2(TLR 2),TLR 4,myeloid differentiation factor 88(MyD 88)]were compared between the two groups.Results After 2 months of treatment,the disease control rate(DCR)of the combined group was 78.95%,which was higher than that of the control group 57.89%(P<0.05),and the objective response rate(ORR)of the combined group was 42.11%,which was not statistically significant compared with 26.32%of the control group(P>0.05).After 2 months of treatment,AFP,CA199,AFU and CEA in combination group were lower than those in control group(P<0.05),TLR2,TLR4 and MyD88 in combination group were lower than those in control group(P<0.05).There was no significant difference in the incidence of pain,fatigue,diarrhea,thrombocytopenia,hypertension,proteinuria and hand-foot syndrome between the two groups(P>0.05).The incidence of fever in combination group(15.79%)was lower than that in control group(36.84%)(P<0.05).The median overall survival(OS)and median progression-free survival(PFS)in combination group were higher than those in control group(P<0.05).Conclusion Lenvatinib combined with TACE is effective in the treatment of liver cancer,which can improve the level of immune dysfunction and tumor markers,increase ORR,OS and PFS,and the adverse reactions are controllable.