2025 年第 2 期 第 20 卷

信迪利单抗加贝伐珠单抗联合经肝动脉化疗栓塞术治疗晚期肝癌的临床研究

Clinical study of sintilimab plus bevacizumab combined with transcatheter arterial chemoembolization in the treatment of advanced liver cancer

作者：涂江江1赵燕仪1石援援1薛峰1翁俊2李思明2

英文作者：Tu Jiangjiang1 Zhao Yanyi1 Shi Yuanyuan1 Xue Feng1 Weng Jun2  Li Siming2

单位：1桂林医学院附属医院肿瘤内科，桂林541001；2桂林医学院附属医院肝胆外科，桂林541001

英文单位：1Department of Oncology the Affiliated Hospital of Guilin Medical University Guilin 541001 China; 2Department of Hepatobiliary Surgery the Affiliated Hospital of Guilin Medical University Guilin 541001 China

关键词：晚期肝癌；经肝动脉化疗栓塞术；信迪利单抗；贝伐珠单抗；肿瘤标志物；免疫功能

英文关键词：Advancedlivercancer;Transhepaticarterialchemoembolization;Sindilimab;Bevacizumab;Tumormarkers;Immunefunction

• 摘要：

• 目的 探讨信迪利单抗+贝伐珠单抗联合经肝动脉化疗栓塞术（TACE）治疗晚期肝癌的临床效果。方法 选取2022年11月至2023年12月桂林医学院附属医院收治的60例晚期肝癌患者，按照随机数字表法分为对照组、观察组，各30例。对照组以TACE+贝伐珠单抗治疗，观察组在对照组基础上增加信迪利单抗治疗。比较2组临床疗效、肿瘤标志物、淋巴细胞水平、预后生存期及安全性。结果 观察组客观缓解率、疾病控制率高于对照组［66.7%(20/30)比40.0%(12/30)、83.3%(25/30)比60.0%(18/30)］（均P＜0.05）。2组患者治疗后肿瘤标志物甲胎蛋白、癌胚抗原、糖类抗原199水平均低于治疗前，且观察组肿瘤标志物水平均低于对照组（均P＜0.05）。治疗后，2组CD+3、CD+4、CD+4/CD+8比值均高于治疗前，且观察组高于对照组，CD+8水平低于治疗前，且观察组低于对照组，差异均有统计学意义（均P＜0.05）。观察组疾病进展时间、无进展生存期、总生存期均高于对照组［（6.1±1.4）个月比（4.9±1.4）个月、（7.9±1.7）个月比（6.5±1.4）个月、（11.2±2.1）个月比（9.7±2.0）个月］（均P＜0.05）。观察组不良反应发生率与对照组比较差异无统计学意义(P=0.739)。结论 TACE术后联用信迪利单抗与贝伐珠单抗治疗晚期肝癌可改善近期疗效，抑制肿瘤标志物水平，提升患者免疫功能，延长患者预后生存时间，且治疗安全性良好。

• Objective To investigate the clinical effect of sintilimab plus bevacizumab combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced liver cancer. Methods A total of 60 patients with advanced liver cancer admitted to the Affiliated Hospital of Guilin Medical University from November 2022 to December 2023 were selected. According to the random number table method, they were divided into the control group and the observation group, with 30 cases in each group. The control group was treated with TACE and bevacizumab, and the observation group was treated with sintilimab on the basis of the control group. The clinical efficacy, tumor markers, lymphocyte levels, prognosis and survival time and safety were compared between the two groups. Results The objective  remission rate and disease control rate of the observation group were higher than those of the control group ［66.7%(20/30) vs 40.0%(12/30), 83.3%(25/30) vs 60.0%(18/30)］(both P＜0.05). After treatment, the levels of tumor markers alpha-fetoprotein, carcinoembryonic antigen and carbohydrate antigen 199 in the two groups were lower than those before treatment, and the levels of tumor markers in the observation group were lower than those in the control group (all P＜0.05). After treatment, the CD+3, CD+4, and CD+4/CD+8 ratios in both groups were higher than those before treatment, and those in the observation group were higher than those in the control group; the CD+8 level was lower than that before treatment, and that in the observation group was lower than that in the control group (all P＜0.05). The disease progression time, progression-free survival time and overall survival time of the observation group were higher than those of the control group ［(6.1±1.4)months vs (4.9±1.4)months, (7.9±1.7)months vs (6.5±1.4)months, (11.2±2.1)months vs (9.7±2.0)months］(all P＜0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group (P=0.739). Conclusion Sintilimab combined with bevacizumab combined with TACE has a good application in the treatment of advanced liver cancer, which can improve the short-term efficacy level, inhibit the level of tumor markers, improve the immune function of patients, prolong the prognosis and survival time of patients, and the treatment safety is good.