卡瑞利珠单抗联合TACE对伴微血管侵犯肝细胞癌患者肿瘤标志物、血管生成因子和血清PD-1、PD-L1的影响

Effect of Carrelizumab Combined with TACE on Tumor Markers,Angiogenesis Factors and Serum PD-1 and PD-L1 in Patients with Hepatocellular Carcinoma with Microvascular Invasion

目的:观察卡瑞利珠单抗联合肝动脉化疗栓塞术(TACE)对伴微血管侵犯肝细胞癌(HCC)患者肿瘤标志物、血管生成因子和血清程序性细胞死亡蛋白-1(PD-1)、程序性死亡配体-1(PD-L1)的影响。方法:根据随机数字表法将2021年6月~2023年7月期间我院收治的121例伴微血管侵犯HCC患者分为对照组(n=60,接受肝癌根治术和TACE治疗)和研究组(n=61,对照组的基础上接受卡瑞利珠单抗治疗)。对比两组疗效、血清肿瘤标志物水平[甲胎蛋白(AFP)、癌胚抗原(CEA)、异常凝血酶原(PIVKA-Ⅱ)、糖类抗原199(CA199)]、血管生成因子水平[血管内皮生长因子受体2(VEGF-R2)、血管生成素-2(Ang-2)、血管内皮生长因子(VEGF)]、血清PD-1、PD-L1水平、不良反应。结果:与对照组相比,研究组的临床总有效率更高(P<0.05)。与对照组治疗后相比,研究组CEA、AFP、CA199、PIVKA-Ⅱ、VEGF、VEGF-R2、Ang-2、PD-1、PD-L1更低(P<0.05)。两组不良反应发生率比较未见差异(P>0.05)。结论:卡瑞利珠单抗联合TACE治疗伴微血管侵犯HCC患者,可改善血清肿瘤标志物,可抑制血管生成和降低血清PD-1、PD-L1水平,有效控制疾病进展。

Objective:To observe the effects of carrelizumab combined with transcatheter arterial chemoembolization(TACE)on tumor markers,angiogenic factors,serum programmed cell death protein-1(PD-1)and programmed death ligand-1(PD-L1)in patients with hepatocellular carcinoma(HCC)with microvascular invasion.Methods:121 HCC patients with microvascular invasion who were admitted to our hospital from June 2021 to July 2023 were divided into control group(n=60,receiving radical resection of liver cancer and TACE treatment)and study group(n=61,receiving carrelizumab treatment on the basis of control group)according to the random number table method.The efficacy,serum tumor marker levels[alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),abnormal prothrombin(PIVKA-II),carbohydrate antigen 199(CA199)],angiogenesis factor levels[vascular endothelial growth factor receptor 2(VEGF-R2),angiopoietin-2(Ang-2),vascular endothelial growth factor(VEGF)],serum PD-1 and PD-L1 levels,adverse reactions were compared between two groups(P>0.05).Results:Compared with control group,the total clinical effective rate in study group was higher(P<0.05).Compared with control group after treatment,CEA,AFP,CA199,PIVKA-II,VEGF,VEGF-R2,Ang-2,PD-1 and PD-L1 in study group were lower(P<0.05).There was no difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:Carrelizumab combined with TACE in the treatment of HCC patients with microvascular invasion,which can improve the serum tumor markers,inhibit angiogenesis and reduce serum PD-1 and PD-L1 levels,and effectively control disease progression.