摘要
目的 探讨介入联合仑伐替尼和程序性细胞死亡受体-1(PD1)抗体治疗晚期肝癌的疗效及对外周血异常凝血酶原(APT)、甲胎蛋白(AFP)的影响。方法 选取2019年2月至2019年4月间上海杨思医院接受治疗的80例晚期肝癌患者。给予介入治疗联合仑伐替尼治疗的39例患者纳入对照组,在对照组的基础上给予PD1抗体辅助治疗的41例患者纳入试验组。比较两组临床疗效、血清APT、AFP、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)水平变化情况、生存率及不良反应发生情况。结果 试验组总有效率80.5%,高于对照组的53.9%,差异有统计学意义(P<0.05)。治疗前,两组外周血APT、AFP结果比较,差异无统计学意义(P>0.05)。治疗后,两组外周血APT、AFP均随着时间的推移而下降,且试验组低于对照组,差异均有统计学意义(均P<0.05)。治疗后,两组患者肝功能均较治疗前改善,且试验组优于对照组,差异均有统计学意义(均P<0.05)。试验组6个月、12个月及18个月生存率均高于对照组,差异均有统计学意义(均P<0.05)。两组发热、上消化道出血发生情况比较,差异无统计学意义(P>0.05)。试验组肝区疼痛、白细胞减少显著高于对照组,差异均有统计学意义(均P<0.05)。结论 在晚期肝癌患者中应用介入联合仑伐替尼、PD1抗体治疗疗效显著,可有效改善外周血APT和AFP水平。
Objective To study the efficacy of interventional therapy combined with lenvatinib and programmed cell death receptor 1(PD-1) antibodies for advanced liver cancer and the effects on abnormal prothrombin(APT) and alpha-fetoprotein(AFP) in peripheral blood. Methods Eighty patients with advanced liver cancer who received treatment at Shanghai Yangsi Hospital were selected from February 2019 to April 2019. Forty-one patients who received interventional therapy combined with lenvatinib and PD-1 antibodies were included in an experimental group and 39 patients who received interventional therapy combined with lenvatinib were included in a control group. Clinical efficacy, changes in serum APT, AFP, alaninetransaminase(ALT), aspartate transaminase(AST), total bilirubin(TBIL), survival rate and the incidence of adverse reactions were compared between the two groups. Results After treatment, the overall efficacy rate was 80.5% in the experimental group, which was higher than 53.9% of control group(P<0.05). Before treatment, there was no significant difference in APT and AFP test results in peripheral blood between experimental group and control group(P>0.05). After treatment, APT and AFP in peripheral blood decreased in both groups over time, and the levels were lower in the experimental group than in the control group(all P<0.05). After treatment, liver function was significantly improved in the two groups compared with before the treatment with the experimental group significantly better than the control group(all P<0.05). The 6-, 12-and 18-month survival rate was significantly higher in experimental group than in control group(all P<0.05). There was no significant difference in the incidence of fever and upper gastrointestinal bleeding between the two groups(P>0.05). The liver pain and leucopenia were significantly higher in the experimental group than in the control group(all P<0.05). Conclusion In patients with advanced liver cancer, interventional therapy combined with levatinib and PD-1 has a significant therapeutic effect, which may be related to the effective improvement of APT and AFP levels in peripheral blood.
作者
顾卫芹
张雯
沈忠培
张罡
GU Wei-qin;ZHANG Wen;SHEN Zhong-pei;ZHANG Gang(Department of Liver Oncology,Shanghai Yangsi Hospital,Shanghai 200126,China;Interventional Department,Shanghai Zhongshan Hospital,Shanghai 200032,China)
出处
《中国肿瘤临床与康复》
2022年第7期802-805,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
