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

摘要 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。

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

ABSTRACT 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.