信迪利单抗联合微波消融治疗肝切除后复发性肝癌的临床研究

Clinical study of sintilimab combined with microwave ablation in the treatment of recurrent hepatocellular carcinoma after hepatectomy

摘要:

目的 探讨信迪利单抗联合微波消融治疗肝切除后复发性肝癌的临床效果。方法 回顾性分析2021年2月—2022年4月长治医学院附属和济医院收治的83例肝切除后复发性肝癌患者的病历资料，以治疗方法不同分为观察组（43例）、对照组（40例）。对照组采用微波消融治疗，观察组在对照组基础上采用信迪利单抗治疗。比较两组近期临床疗效、肿瘤标志物、肝功能、并发症。术后随访3年，记录两组生存情况。结果 观察组疾病控制率和客观缓解率均高于对照组（P <0.05）。观察组治疗前后甲胎蛋白、糖类抗原199和癌胚抗原的差值均大于对照组（P <0.05）。观察组治疗前后丙氨酸转氨酶、天冬氨酸转氨酶和总胆红素的差值均大于对照组（P <0.05）。对照组与观察组并发症总发生率比较，差异无统计学意义（P >0.05）。观察组总生存率高于对照组（P <0.05）。结论 信迪利单抗联合微波消融治疗肝切除后复发性肝癌效果确切，可降低肿瘤标志物水平，改善肝功能，安全性可靠，且可延长患者生存时间。

Abstract:

Objective To study the clinical effect of sintilimab combined with microwave ablation in the treatment of recurrent hepatocellular carcinoma after hepatectomy.Methods A retrospective analysis was conducted on the medical records of 83 patients with recurrent hepatocellular carcinoma after hepatectomy admitted to our hospital from February 2021 to April 2022. According to different treatment methods, they were divided into the observation group (n = 43) and the control group (n = 40). The control group was treated with the microwave ablation, while the observation group was additionally treated with sintilimab. The short-term clinical efficacy, tumor markers, liver function and complications of the two groups were compared. The patients were followed up for 3 years after the operation, and the survival of patients in the two groups was recorded.Results The disease control rate and objective response rate of the observation group were both higher than those of the control group (P < 0.05). The differences of alpha-fetoprotein, carbohydrate antigen 199, and carcinoembryonic antigen levels before and after treatment in the observation group were all greater than those in the control group (P < 0.05). The differences of alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels before and after treatment in the observation group were all greater than those in the control group (P < 0.05). There was no statistically significant difference in the overall incidence of complications between the control group and the observation group (P > 0.05). After a 3-year follow-up, the survival rate of the observation group was 58.14%, and that of the control group was 37.50%. The overall survival rate of the observation group was higher than that of the control group (P < 0.05).Conclusion Sintilimab combined with microwave ablation has a definite effect in the treatment of recurrent hepatocellular carcinoma after hepatectomy. It reduces tumor marker levels, improves liver function, demonstrates reliable safety, and has the potential to prolong patient survival.