摘要
目的:探究程序性细胞死亡蛋白-1(PD-1)抑制剂联合乐伐替尼治疗晚期原发性肝癌的临床疗效及对患者血清血管内皮生长因子(VEGF)、可溶性血管细胞黏附因子(sVCAM1)表达的影响。方法:选取本院2019年4月—2021年4月收治的晚期不能进行手术治疗的原发性肝癌患者120例,随机分为两组,各60例,观察组采用PD-1抑制剂联合乐伐替尼治疗,对照组采用乐伐替尼单药治疗。比较两组患者的近期疗效、血清VEGF、sVCAM1表达水平、肝功能指标及不良反应发生情况。结果:观察组治疗总有效率为70.00%,显著高于对照组的48.33%(P<0.05)。治疗前,两组患者的VEGF、sVCAM1、谷草转氨酶(AST)、谷丙转氨酶(ALT)、血清总胆红素(TBIL)及碱性磷酸酶(ALP)水平差异无统计学意义(P>0.05);治疗后,观察组与对照组的VEGF[(225.47±45.09)、(247.64±49.53)]ng/mL、sVCAM1[(637.42±127.45)、(712.55±142.51)]ng/mL,AST[(38.72±7.74)、(45.33±9.07)]U/L、ALT[(40.57±8.11)、(47.36±9.47)]U/L、TBIL[(10.38±2.08)、(12.51±2.50)]μmol/L、ALP[(64.57±12.91)、(72.35±14.47)]U/L水平均低于治疗前,且观察组低于对照组(P<0.05)。观察组与对照组患者不良反应发生率(21.67%vs 23.33%)比较,差异无统计学意义(P>0.05)。结论:PD-1抑制剂联合乐伐替尼可以显著提高晚期原发性肝癌患者的治疗效果,改善患者肝功能及免疫功能等,且安全性较好。
Objective To explore the clinical efficacy of PD-1 inhibitor combined with lenvatinib in the treatment of advanced primary liver cancer and its effects on the expression of serum vascular endothelial growth factor(VEGF)and soluble vascular cell adhesion molecule-1(sVCAM1)in patients.Methods A total of 120 patients with advanced primary liver cancer who could not be operated in our hospital between April 2019 to April 2021 were selected and randomly divided into two groups,with 60 cases in each group.The observation group was treated with PD-1 inhibitors and combined with lenvatinib,and the control group was treated with lenvatinib alone.The short-term curative effect,serum VEGF and sVCAM1 expression levels,liver function and occurrence of adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group 70.00%was significantly higher than that in the control group 48.33%(P<0.05).Before treatment,there was no statistical difference in the expression levels of VEGF[(225.47±45.09)(247.64±49.53)]ng/mL and sVCAM1[(637.42±127.45)(712.55±142.51)]ng/mL,aspartate aminotransferase(AST)[(637.42±127.45)(712.55±142.51)]ng/mL,glutamate aminotransferase(ALT)[(40.57±8.11)(47.36±9.47)]U/L,serum total bilirubin(TBIL)[(10.38±2.08)(12.51±2.50)]μmol/L and alkaline phosphatase(ALP)[(64.57±12.91)(72.35±14.47)]U/L of the two groups(P>0.05)after treatment,the levels of VEGF and sVCAM1,AST,ALT,TBIL,and ALP decreased(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(21.67%vs 23.33%)(P>0.05).Conclusion PD-1 inhibitor combined with lenvatinib can significantly improve the treatment effect of patients with advanced primary liver cancer,improve liver function and immune function,etc.,and have certain safety.
作者
刘妍
马珊
付正传
LIU Yan;MA Shan;FU Zheng-zhuan(Department of Oncology,Zaozhuang Central Hospital,Shandong Guoxin Yiyang Group,Shandong Zaozhuang(277000),China)
出处
《中国中西医结合外科杂志》
CAS
2023年第2期211-215,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
