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探究卡瑞利珠单抗(Camrelizumab,Cam)联合富马酸替诺福韦二吡呋酯(Tenofovir disoproxil fumarate,TDF)系统治疗乙型肝炎病毒相关性肝细胞癌(HBV-HCC)的临床疗效及安全性。纳入2019年1月至2022年12月就诊于我院的HBV-HCC患者255例，根据不同治疗方法分为TDF组125例，Cam+TDF组130例。治疗3个疗程后，Cam+TDF组客观缓解率(ORR)(68.46%)高于TDF组(44.00%)(P<0.05);Cam+TDF组疾病控制率(DCR)(86.15%)高于TDF组(73.60%)(P<0.05)。利用Log-rank检验比较两组无进展生存期(PFS)和总生存期(OS)，差异均有统计学意义(P<0.05)。Cam+TDF组癌胚抗原(CEA)、甲胎蛋白(AFP)、异常凝血酶原Ⅱ(PIVKA-Ⅱ)、α-L-岩藻糖苷酶(AFU)、乙肝病毒脱氧核糖核酸(HBV-DNA)、乙型肝炎病毒表面抗原(HBs Ag)、CD8+、血管生成素-2(Ang-2)、CMIA法测定肝细胞生长因子(HGF)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)水平均低于TDF组(P<0.05);Cam+TDF组CD4+、CD4+/CD8+水平高于TDF组(P<0.05)。Cam+TDF组反应性皮肤毛细血管增生症发生率(66.92%)显著高于TDF组(0%)(P<0.05)。Cam联合TDF治疗HBV-HCC疗效显著，可增强机体免疫功能并抑制病毒复制和肿瘤生长，有效改善患者肝功能，延长患者生存时间，药物安全性较高。
Abstract：This study aimed to evaluate the clinical efficacy and safety of camrelizumab (Cam) combined with tenofovir disoproxil fumarate (TDF) in the treatment of hepatitis B virus-associated hepatocellular carcinoma(HBV-HCC).A total of 255 patients with HBV-HCC who visited our hospital between January 2019 and December 2022 were included in the study.Patients were divided into the TDF group (125 cases) and the Cam+TDF group (130 cases) based on their treatment regimen.After three treatment cycles,the objective response rate (ORR) was significantly higher in the Cam+TDF group (68.46%) than in the TDF group(44.00%)(P<0.05).Similarly,the disease control rate (DCR) was higher in the Cam+TDF group(86.15%) compared to the TDF group (73.60%)(P<0.05).The Log-rank test showed significant differences in progression-free survival (PFS) and overall survival (OS) between the two groups (P<0.05).Levels of carcinoembryonic antigen (CEA),alpha-fetoprotein (AFP),protein induced by vitamin K absence-II (PIVKA-Ⅱ)，α-L-fucosidase (AFU),hepatitis B virus DNA (HBV-DNA),hepatitis B surface antigen (HBs Ag),CD8+,angiopoietin-2 (Ang-2),hepatocyte growth factor (HGF),alanine aminotransferase (ALT),aspartate aminotransferase (AST),and total bilirubin (TBIL),as measured by the chemiluminescent microparticle immunoassay (CMIA) method,were significantly lower in the Cam+TDF group than in the TDF group (P<0.05).Conversely,CD4~+levels and the CD4+/CD8~+ratio were significantly higher in the Cam+TDF group than in the TDF group (P<0.05).The incidence of reactive cutaneous capillary hyperplasia in the Cam+TDF group (66.92%) was significantly higher than that in the TDF group (0%)(P<0.05).These findings indicate that Cam combined and TDF demonstrates significant therapeutic efficacy for HBV-HCC,enhancing immune function,inhibiting viral replication and tumor growth,improving liver function,and prolonging patient survival,while maintaining a favorable safety profile.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.250010
中图分类号:R735.7;R512.62
引用信息:
[1]唐晶,温秀梅,郝桂锋.卡瑞利珠单抗联合TDF系统治疗乙型肝炎病毒相关肝癌的临床疗效及安全性分析[J].病毒学报,2025,41(03):775-783.DOI:10.13242/j.cnki.bingduxuebao.250010.
基金信息:
国家中管局科技司-浙江省中管局共建科技项目(项目号:GZY-ZJ-KJ-23044),题目:肌骨超声引导小针刀联合皮内针序贯治疗活动期类风湿关节炎的随机对照研究; 浙江省中医药科技计划项目(项目号:2024ZL772),题目:益骨汤联合螺旋稳定肌肉链技术对退行性腰椎滑脱症的临床疗效研究~~
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