| 黎经何,邹孟达,张涛,等.索拉非尼联合程序性死亡受体 1抑制剂预防肝细胞癌切除术后病理诊断微血管侵犯阳性病人早期复发的效果[J].安徽医药,2024,28(8):1655-1658. |
| 索拉非尼联合程序性死亡受体 1抑制剂预防肝细胞癌切除术后病理诊断微血管侵犯阳性病人早期复发的效果 |
| Efficacy of sorafenib combined with PD-1 in the prevention of early recurrence in patients with MVI positive disease after resection of HCC |
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| DOI：10.3969/j.issn.1009-6469.2024.08.037 |
| 中文关键词: 癌，肝细胞 微血管侵犯 索拉非尼 程序性死亡受体 1 复发 |
| 英文关键词: Carcinoma,hepatocellular Microvascular invasion Sorafenib PD-1 Recurrence |
| 基金项目:重庆市科卫联合项目( 2021MSXM308) |
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| 中文摘要: |
| 目的探索肝细胞癌(HCC)根治性切除术后病理诊断微血管侵犯( MVI)阳性病人予索拉非尼联合程序性死亡受体 1抑制剂( PD-1)辅助治疗预防肝癌早期复发的效果。方法收集 2018年 1月至 2020年 10月重庆市人民医院和陆军军医大学西南医院收治的 HCC根治性切除术后病理诊断 MVI阳性的病人 94例，分为观察组与对照组，各 47例，观察组予索拉非尼联合 PD-1辅助治疗，对照组未予索拉非尼和 PD-1辅助治疗。比较两组无瘤生存期( DFS)及总生存期( OS)。结果两组临床特征相似。观察组 6个月、 1年、 2年 DFS率分别为 97.9%、70.2%和 38.3%，对照组分别为 74.5%、48.9 %和 25.5%；观察组 6个月、 1年、 2年 OS率分别为 100%、93.6%、46.8%，对照组分别为 97.9%、78.7%、36.2%；观察组 OS及 DFS均显著优于对照组( P<0.05)。观察组部分病人不良反应发生率较高，如高血压、皮疹、肝功能异常等，但大部分为 1级或 2级，临床可控制及可治疗，安全性高。结论肝细胞癌根治性切除术后病理诊断 MVI阳性病人予索拉非尼联合 PD-1治疗可减少肝癌术后早期复发率，提高病人生存时间，治疗安全可靠。 |
| 英文摘要: |
| Objective To explore the efficacy of adjuvant sorafenib combined with PD-1 inhibitor in preventing early recurrence of HCC in patients with pathologically diagnosed microvascular invasion (MVI)-positive disease after curative resection of hepatocellular carcinoma (HCC). Methods The clinical data of 94 patients with MVI-positive HCC after curative resection in Chongqing GeneralHospital and Southwest Hospital, Third Military Medical University from January 2018 to October 2020 were retrospectively collectedand divided into an observation group and a control group, with 47 cases in each group. The observation group received sorafenib com-bined with PD-1 adjuvant treatment, while the control group did not receive sorafenib and PD-1 adjuvant treatment. Compare the dis- ease-free survival (DFS) and overall survival (OS) between two groups.Results The clinical features of the two groups were similar.The 6-month, 1-year and 2-year DFS rates in the observation group were 97.9%, 70.2% and 38.3%, and in the control group were74.5%, 48.9% and 25.5%, respectively. The 6-month, 1-year and 2-year OS rates in the observation group were 100%, 93.6% and46.8%, respectively, while in the control group were 97.9%, 78.7% and 36.2%. The OS and DFS of observation group were significantlybetter than those of control group (P<0.05). Although the incidence of some adverse reactions in observation group was high, such as hy-pertension, rash, abnormal liver function, etc., most of them were grade 1 or grade 2, which could be controlled and treated clinically.Conclusion In patients with pathologically diagnosed MVI positive disease after curative resection of HCC, sorafenib plus PD-1 adju-vant therapy can reduce the early postoperative recurrence rate and improve the survival time of patients, and the treatment process issafe and reliable. |
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