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微波消融术后辅助PD-1抑制剂治疗肝细胞癌的临床疗效
Clinical efficacy of adjuvant treatment with PD-1 inhibitors for hepatocellular carcinoma after microwave ablation
- 局解手术学杂志 2024年33卷第11期 页码：970-974
- 作者机构：
中国人民解放军海军第九七一医院肿瘤科，山东 青岛 266071
- 作者简介：
侯晓玮，E-mail：bluesky5581@126.com
- 基金信息：山东省医药卫生科技发展计划项目(202003100478)
DOI：10.11659/jjssx.10E023057
中图分类号： R453.9;R735.7纸质出版日期：2024-11-25，
收稿日期：2023-10-13，
- 稿件说明：
移动端阅览
侯晓玮,秦秀菊,庄兴俊等.微波消融术后辅助PD-1抑制剂治疗肝细胞癌的临床疗效[J].局解手术学杂志,2024,33(11):970-974.
HOU Xiao-wei,QIN Xiu-ju,ZHUANG Xing-jun,et al.Clinical efficacy of adjuvant treatment with PD-1 inhibitors for hepatocellular carcinoma after microwave ablation[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):970-974.
侯晓玮,秦秀菊,庄兴俊等.微波消融术后辅助PD-1抑制剂治疗肝细胞癌的临床疗效[J].局解手术学杂志,2024,33(11):970-974. DOI： 10.11659/jjssx.10E023057.
HOU Xiao-wei,QIN Xiu-ju,ZHUANG Xing-jun,et al.Clinical efficacy of adjuvant treatment with PD-1 inhibitors for hepatocellular carcinoma after microwave ablation[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):970-974. DOI： 10.11659/jjssx.10E023057.
摘要
目的
2
观察微波消融术后辅助PD-1抑制剂治疗肝细胞癌患者的临床疗效和治疗前后患者淋巴细胞亚群的变化。
方法
2
纳入我院56例接受微波消融术的肝细胞癌患者，根据治疗方法不同分为2组，每组28例。其中A组患者采用微波消融术后辅助PD-1抑制剂治疗；B组患者单纯行微波消融术。观察微波消融术的局部疗效、辅助PD-1抑制剂治疗后患者生存情况及相关不良反应发生情况。采集患者外周静脉血，分别检测2组患者微波消融术前、B组患者微波消融术后及A组患者6周期免疫治疗后淋巴细胞亚群数量。
结果
2
A组病例完全消融率与B组比较差异无统计学意义（89.3%
vs.
85.7%，
P
=0.69），A组病灶完全消融率与B组比较差异无统计学意义（91.7%
vs.
85.3%，
P
=0.40）。A组患者的中位无进展生存期（mPFS）尚未达到，B组患者的mPFS为12.6个月，2组患者mPFS比较，差异有统计学意义（
P
=0.03）；2组患者中位总生存期（mOS）均未达到。治疗后A组患者CD
4
+
T淋巴细胞比例较B组患者明显升高[（37.05±2.22）%
vs.
（29.23±2.88）%，
P
=0.03
]
，CD
8
+
T淋巴细胞比例[（21.08±2.23）%
vs.
（27.18±1.75）%，
P
=0.04
]
和调节T细胞（Treg细胞）比例[（4.26±0.31）%
vs.
（5.22±0.34）%，
P
=0.04
]
明显下降。所有患者微波消融术后均未出现严重不良反应，A组28例患者行PD-1抑制剂治疗后均未出现3级以上不良反应。
结论
2
微波消融术后辅助PD-1抑制剂治疗能够延长患者的无进展生存期，强化患者T淋巴细胞的功能，削弱免疫抑制性细胞的作用，其可能是延缓肝癌微波消融术后复发的一种有效策略。
Abstract
Objective
2
To observe the clinical efficacy of adjuvant PD-1 inhibitor in the treatment of patients with hepatocellular carcinoma after microwave ablation and the changes of lymphocyte subsets before and after treatment.
Methods
2
A total of 56 patients with hepatocellular carcinoma who underwent microwave ablation in our hospital were randomly divided into two groups according to different treatments，with 28 cases in each group. Patients in the group A received adjuvant treatment with PD-1 inhibitors after microwave ablation，while patients in the group B received microwave ablation alone. The local efficacy of microwave ablation，the survival of patients after adjuvant treatment of PD-1 inhibitor and the occurrence of related adverse reactions were observed. Peripheral venous blood was collected to detect the number of T lymphocyte subsets before microwave ablation in the two groups，after microwave ablation in the group B，and after six cycles of immunotherapy in the group A.
Results
2
There was no significant difference in the complete ablation rate of cases between group A and group B （89.3%
vs.
85.7%，
P
=0.69），and there was no significant difference in the complete ablation rate of lesions between group A and group B （91.7%
vs.
85.3%，
P
=0.40）. The median progression-free survival （mPFS） of the group A was not yet reached，the mPFS of group B was 12.6 months，and there was a statistically significant difference in the mPFS between the two groups（
P
=0.03）.The median overall survival （mOS） of the two group were not yet reached. The proportion of CD
4
+
T lymphocytes after treatment in the group A significantly increased compared with that in the group B ［（37.05±2.22）%
vs.
（29.23±2.88）%，
P
=0.03］，while the proportion of CD
8
+
T lymphocytes ［（21.08±2.23）%
vs.
（27.18±1.75）%，
P
=0.04）］ and the proportion of Treg cells［（4.26±0.31）%
vs.
（5.22±0.34）%，
P
=0.04］ significantly decreased. Ther
e was no serious adverse reactions in all patients after microwave ablation，and 28 patients in the group A had no adverse reactions above grade 3 after PD-1 inhibitor treatment.
Conclusion
2
Adjuvant PD-1 inhibitor therapy after microwave ablation can prolong the progression-free survival of patients，enhance the function of T lymphocytes，and weaken the role of immunosuppressive cells，which may be an effective strategy to delay the recurrence of liver cancer after microwave ablation.
关键词
微波消融PD-1抑制剂肝细胞癌淋巴细胞亚群
Keywords
microwave ablationPD-1 inhibitorhepatocellular carcinomalymphocyte subsets
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