靶向药物联合免疫治疗在原发性肝癌合并微血管侵犯的术后近期复发的作用

The Preventive Effect of Target Immune Therapy on the Short-Term Recurrence of Primary Liver Cancer with MVI

摘要: 目的：探索靶免治疗对合并MVI的原发性肝癌术后近期复发的预防作用。方法：回顾性分析我院在2018年1月至2020年5月期间的116例合并MVI的原发性肝癌患者临床资料，根据肝切除术后治疗方法分为两组：对照组57例术后仅采用TACE术治疗，治疗组59例术后采用TACE + 靶免联合治疗，比较两组肝切除术后肝功能、T淋巴细胞亚群、肿瘤标志物变化，并随访1年，分析术后复发、无瘤生存情况。结果：治疗组患者1年后CA199 (301.12 ± 19.68) U/mL、癌胚抗原(92.13 ± 10.11) ng/mL、甲胎蛋白水平(428.33 ± 28.45) ng/mL均低于对照组1年后CA199 (332.37 ± 20.34) U/mL、癌胚抗原(113.13 ± 15.58) ng/mL、甲胎蛋白水平(467.89 ± 27.98) ng/mL (P < 0.05)。治疗组患者1年后CD8+ (29.74 ± 3.17)%、CD4+ (46.77 ± 5.58)%、CD3+(63.87 ± 5.67)%、CD4+/CD8+比值(1.95 ± 0.37)均优于对照组1年后CD8+ (27.49 ± 2.49)%、CD4+ (41.54 ± 4.48)%、CD3+ (60.12 ± 3.33)%、CD4+/CD8+比值(1.62 ± 0.27) (P < 0.05)。治疗组术后1年的无瘤生存率66.10%，高于对照组47.37%，1年内复发率8.47%，低于对照组26.32% (P < 0.05)。结论：合并MVI的原发性肝癌患者术后进行靶免治疗，不仅对肝功能影响小，还可降低肝切除术后肝癌的复发率，对合并MVI的原发性肝癌术后近期复发具有预防作用。

Abstract: Objective: Explore the preventive effect of target immune therapy on the short-term recurrence of primary liver cancer with MVI. Methods: A retrospective analysis of the clinical data of 116 patients with primary liver cancer with MVI in our hospital from January 2018 to May 2020, and dividing into two groups according to the treatment method after hepatectomy: for 57 cases in the control group after operation, only TACE was used for treatment, and 59 cases in the treatment group were treated with TACE + target immune combined treatment after hepatectomy. The liver function, T lymphocyte subsets, and tumor markers were compared between the two groups after hepatecto-my. Follow up for 1 year to analyze postoperative recurrence and tumor-free survival. Results: After 1 year, CA199 (301.12 ± 19.68) U/mL, carcinoembryonic antigen (92.13 ± 10.11) ng/mL, and al-pha-fetoprotein levels (428.33 ± 28.45) ng/mL of patients in the treatment group were lower than those in the control group after 1 year, CA199 (332.37 ± 20.34) U/mL, carcinoembryonic antigen (113.13 ± 15.58) ng/mL, alpha-fetoprotein level (467.89 ± 27.98) ng/mL (P < 0.05). After 1 year, CD8+ (29.74 ± 3.17)%, CD4+ (46.77 ± 5.58)%, CD3+ (63.87 ± 5.67)%, CD4+/CD8+ ratio (1.95 ± 0.37) of patients in the treatment group were better than CD8+ (27.49 ± 2.49)%, CD4+ (41.54 ± 4.48)%, CD3+ (60.12 ± 3.33)%, CD4+/CD8+ ratio (1.62 ± 0.27) (P < 0.05). The 1-year tumor-free survival rate of the treatment group was 66.10% higher than that of the control group 47.37%, and the re-currence rate within 1 year was 8.47% lower than that of the control group 26.32% (P < 0.05). Con-clusion: Target immune therapy for patients with primary liver cancer with MVI after surgery not only has a small impact on liver function, but also reduces the recurrence rate of liver cancer after hepatectomy, and prevents the short-term recurrence of primary liver cancer with MVI.