殷云飞 鲁邱阳

【摘要】 目的：探討给予中晚期肝癌患者程序性死亡受体（PD-1）单抗治疗的近期效果以及对其外周血T淋巴细胞亚群相关指标的影响。方法：选取2018年7月-2019年8月本院收治的50例中晚期肝癌患者，随机数字表法将其分为研究组和对照组，各25例，对照组给予甲苯磺酸索拉非尼片以及奥沙利铂，研究组给予抗PD-1单抗治疗。比较两组近期疗效、外周血T淋巴细胞亚群指标水平、血清细胞因子水平及不良反应发生情况。结果：治疗3个月后，研究组总有效率为76.00%，高于对照组的48.00%，差异有统计学意义（P<0.05）。研究组死亡率为4.00%，与对照组的12.00%比较，差异无统计学意义（P>0.05）。治疗前，两组外周血CD3+、CD4+、CD8+、CD4+/CD8+水平及aFGF、bFGF、VEGF水平比较，差异均无统计学意义（P>0.05）;治疗后，研究组T淋巴细胞亚群各指标水平均高于对照组，各血清细胞因子水平均低于对照组，差异均有统计学意义（P<0.05）。研究组不良反应发生率为16.00%，低于对照组的44.00%，差异有统计学意义（P<0.05）。结论：给予中晚期肝癌患者抗PD-1单抗治疗近期效果明显，可有效改善患者外周血T淋巴细胞亚群指标水平及血清细胞因子水平，控制病情发展。

【关键词】 肝癌 PD-1 淋巴细胞亚群

Effect of Anti PD-1 Monoclonal Antibody on Short-term Efficacy and Peripheral Blood T Lymphocyte Subsets in Patients with Advanced Liver Cancer/YIN Yunfei， LU Qiuyang. //Medical Innovation of China， 2021， 18（13）： 0-022

[Abstract] Objective： To investigate the short-term effect of programmed death receptor （PD-1） monoclonal antibody therapy in patients with advanced liver cancer and its effect on peripheral blood T lymphocyte subsets related indexes. Method： A total of 50 patients with advanced liver cancer admitted to our hospital from July 2018 to August 2019 were selected. They were divided into study group and control group by random number table， 25 cases in each group. The control group was treated with Sorafenib Toluenesulfonate Tablets and Oxaliplatin， and the study group was treated with anti PD-1 monoclonal antibody. The short-term efficacy， peripheral blood T lymphocyte subsets， serum cytokine levels and the incidence of ADR were compared between the two groups. Result： After 3 months of treatment， the total effective rate of the study group was 76.00%， which was higher than 48.00% of the control group， the difference was statistically significant （P<0.05）. The mortality rate in the study group was 4.00%， compared with 12.00% in the control group， the difference was not statistically significant （P>0.05）. Before treatment， there were no significant differences in the levels of CD3+， CD4+， CD8+， CD4+/CD8+ and the levels of aFGF， bFGF and VEGF in peripheral blood between two groups （P>0.05）. After treatment， the levels of T lymphocyte subsets in the study group were higher than those in the control group， and the levels of serum cytokines were lower than those in the control group， the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the study group was 16.00%， lower than 44.00% in the control group， the difference was statistically significant （P<0.05）. Conclusion： Anti PD-1 monoclonal antibody can achieve obvious short-term effect in the treatment of patients with advanced liver cancer， which can effectively improve the levels of peripheral blood T lymphocyte subsets and serum cytokines， and control disease progression.

[Key words] Liver cancer PD-1 Lymphocyte subsets

First-authors address： The Third Affiliated Hospital of Chongqing Medical University， Chongqing 401120， China

doi：10.3969/j.issn.1674-4985.2021.13.005

肝癌是临床常见的恶性肿瘤，相关研究显示我国肝癌发病率以及死亡率均为全球首位[1-2]，严重影响人们的身心健康。肝癌早期诊断困难且病情进展迅速，约80%的患者确诊时已经是中晚期，该类患者往往预后不佳[3-4]。临床上对于早期患者以手术治疗为主，中晚期患者治疗的方法仍然以放射介入、化疗、靶向治疗等手段为主，但治疗结果往往不尽人意[5]。近年来，随着研究进展，免疫治疗逐渐成为肝癌研究的热点，目前研究认为，采取程序性死亡受体PD-1单抗治疗对肿瘤细胞有一定抑制作用，PD-1属于免疫抑制分子，通过调节免疫作用可杀死癌细胞、对抗肿瘤[6-7]。本文主要探讨了给予中晚期肝癌患者抗PD-1单抗治疗的近期效果以及对其外周血T淋巴细胞亚群相关指标的影响作用，以期为临床提供参考，现报道如下。