TACE联合PD-1抑制剂与DC-CIK治疗晚期肝细胞肝癌的临床研究

Clinical study on TACE combined with PD-1 inhibitor and DC-CIK in the treatment of advanced liver cancer

目的分析经肝动脉化疗栓塞术(TACE)联合程序性死亡受体1(PD-1)抑制剂与树突状细胞(DC)-细胞因子诱导的杀伤细胞(CIK)治疗晚期肝细胞肝癌的临床效果。方法前瞻性选择2019年5月至2022年3月扬州大学医学院海安临床学院收治的92例晚期肝细胞肝癌患者,依照随机数字表法将其分为研究组(n=46)及对照组(n=46)。对照组接受TACE联合DC-CIK治疗,研究组在对照组的基础上联合PD-1抑制剂治疗,2组均治疗3个月。对比2组疾病控制率(DCR),成纤维细胞生长因子(FGF)、癌胚抗原(CEA)、甲胎蛋白(AFP)、CD3^(+)、CD4^(+)、CD8^(+)水平,癌症患者生活质量核心量表(QLQ-C30)评分,以及不良反应情况。结果研究组DCR(71.74%)比对照组(50.00%)高(P<0.05)。治疗后,2组FGF、CEA、AFP水平均降低(P<0.05),且研究组更低(P<0.05)。治疗后,2组患者CD3^(+)、CD4^(+)均升高(P<0.05),且研究组更高(P<0.05);CD8^(+)均降低(P<0.05),且研究组更低(P<0.05)。治疗后,2组QLQ-C30评分均升高(P<0.05),且研究组更高(P<0.05)。2组Ⅰ~Ⅳ级甲状腺功能减退、高血压、手足综合征、皮疹发生率比较差异无统计学意义(P>0.05)。结论TACE联合PD-1抑制剂与DC-CIK治疗晚期肝细胞肝癌有效,可降低FGF、CEA、AFP水平,提高免疫功能,改善生存质量,且安全可靠。

Objective To analyze the clinical effect of transhepatic arterial chemoembolization(TACE)combined with programmed death receptor 1(PD-1)inhibitors and dendritic cell(DC)-cytokine induced killer cell(CIK)on advanced hepatocellular carcinoma.Methods A total of 92 patients with advanced hepatocellular carcinoma who were admitted to Hai’an Clinical College,Medical collgeg of Yangzhou University from May 2019 to March 2022 were prospectively selected and divided into study group(n=46)and control group(n=46)according to random number table method.TACE and DC-CIK treatment were given in both groups,and PD-1 inhibitor was additionally used in the study group.The duration of treatment was 3 months.The disease control rate(DCR),fibroblast growth factor(FGF),carcinoembryonic antigen(CEA),alpha fetoprotein(AFP),CD3^(+),CD4^(+),CD8^(+),the quality of life questionnaire-core 30(QLQ-C30)score and adverse reactions were compared between the two groups.Results The DCR of the study group was higher than that of the control group(71.74%vs.50.00%,P<0.05).After treatment,the levels of FGF,CEA,AFP and CD8^(+)were decreased in both groups,while CD3^(+)and CD4^(+)levels and QLQ-C30 score were increased(P<0.05).After treatment,the levels of FGF,CEA,AFP and CD8^(+)in the study group were significantly lower than those in the control group,and CD3^(+)and CD4^(+)levels and QLQ-C30 score in the study group were significantly higher than those in the control group(P<0.05).There were no significant differences in the incidences of gradeⅠ-Ⅳhypothyroidism,hypertension,hand foot syndrome or rash between the two groups(P>0.05).Conclusion TACE combined with PD-1 inhibitor and DC-CIK is effective,safe and reliable in the treatment of advanced liver cancer.It can reduce the levels of FGF,CEA and AFP,improving immune function and quality of life of the patients.