2025 年第 7 期 第 20 卷

卡瑞利珠单抗辅助载药微球治疗原发性肝癌的效果及对患者血清相关因子水平的影响

The effect of camrelizumab assisted drug-loaded microspheres in the treatment of primary liver cancer and its impacts on serum correlation factor levels

作者：周炜1王颖1段朋朋1卢坤1曹莉明2

英文作者：Zhou Wei1 Wang Ying1 Duan Pengpeng1 Lu Kun1 Cao Liming2

单位：1河北省保定市第一中心医院介入科，保定071000；2中国人民解放军联勤保障部队第九八〇医院（白求恩国际和平医院）介入科，石家庄050000

英文单位：1Department of Interventional Baoding No.1 Central Hospital Hebei Province Baoding 071000 China; 2Department of Interventional the 980th Hospital of the Joint Logistic Support Force of the Chinese People′s Liberation Army (Bethune International Peace Hospital) Shijiazhuang 050000 China

关键词：原发性肝癌；卡瑞利珠单抗；载药微球；高尔基体糖蛋白73；甲胎蛋白异质体L3

英文关键词：Primarylivercancer;Camrelizumab;Drug-loadedmicrospheres;Golgiglycoprotein73; Alphafetoproteinheterogeneity-L3

• 摘要：

• 目的 探究卡瑞利珠单抗辅助载药微球治疗原发性肝癌的效果及对患者血清高尔基体糖蛋白73（GP73）、甲胎蛋白和甲胎蛋白异质体L3（AFP-L3）水平的影响。方法 选取河北省保定市第一中心医院2022年1月至2024年1月收治的92例原发性肝癌患者作为研究对象。按照随机数字表法分为联合组和载药微球组，各46例。载药微球组给予载药微球治疗，联合组给予卡瑞利珠单抗辅助载药微球治疗，2组均治疗12周。对比2组患者临床疗效，治疗前后的肿瘤标志物水平、肝功能指标水平、核因子κB、缺氧诱导因子1α（HIF-1α）、T淋巴细胞亚群水平和不良反应。结果 治疗后联合组客观缓解率高于载药微球组［89.1%（41/46）比67.4%（31/46）］（P＜0.05）。治疗后2组患者的GP73、甲胎蛋白、AFP-L3和癌胚抗原、丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、核因子κB、HIF-1α水平均低于治疗前且联合组均低于载药微球组；CD+3、CD+4、CD+4/CD+8比值均明显高于治疗前且联合组均高于载药微球组（均P<0.05）。2组患者的各项不良反应差异均无统计学意义（均P＞0.05）。结论 与单用载药微球相比，卡瑞利珠单抗辅助载药微球治疗原发性肝癌近期效果更好，有助于肝功能恢复，降低血清肿瘤标志物水平，具有一定安全性。

• Objective  To investigate the effect of camrelizumab assisted drug-loaded microspheres in the treatment of primary liver cancer and theirimpacts on serum Golgi glycoprotein 73(GP73), alpha fetoprotein, and alpha fetoprotein heterogeneity-L3(AFP-L3) in patients. Methods A total of 92 patients with primary liver cancer admitted to Baoding No.1 Central Hospital, Hebei Province from January 2022 to January 2024 were selected as the research objects. According to the random number table method, they were divided into combination group and drug-loaded microspheres group, with 46 cases in each group. The drug-loaded microspheres group was treated with drug-loaded microspheres, and the combined group was treated with camrelizumab adjuvant drug-loaded microspheres. Both groups were treated for 12 weeks. The clinical efficacy, levels of tumor markers, liver function indexes, nuclear factor-κB, hypoxia inducible factor-1α (HIF-1α), T lymphocyte subsets and adverse reactions were compared between the two groups before and after treatment. Results After treatment, the objective response rate of the combined group was higher than that of the drug-loaded microspheres group ［89.1%(41/46) vs 67.4%(31/46)］(P<0.05). After treatment, the levels of GP73, alpha fetoprotein, AFP-L3, carcinoembryonic antigen, alanine transaminase, aspartate transaminase, total bilirubin, nuclear factor-κB and HIF-1α in the two groups were lower than those before treatment, and those in the combined group were lower than those in the drug-loaded microspheres group; the CD+3, CD+4, and CD+4/CD+8 ratio were significantly higher than those before treatment, and those in the combined group were higher than those in the drug-loaded microspheres group (all P<0.05). There was no significant difference in adverse reactions between the two groups (all P>0.05). Conclusion Compared with drug-loaded microspheres alone, camrelizumab combined with drug-loaded microspheres has a better short-term effect in the treatment of primary liver cancer, which is helpful to the recovery of liver function, reduces the level of serum tumor markers, and has a certain safety.