【摘要】 目的 探讨血清血管内皮生长因子（VEGF）、甲胎蛋白（AFP）水平对晚期肝癌经导管肝动脉化疗栓塞（TACE）联合程序死亡受体1(PD-1)抑制剂疗效的评估价值。方法 选择80例晚期肝癌患者，均接受TACE联合PD-1抑制剂治疗。分别于治疗前、治疗2个周期后采集静脉血，检测血清VEGF、AFP；绘制受试者工作特征曲线，用曲线下面积评估血清VEGF、AFP水平评估晚期肝癌治疗后客观缓解、转化成功的价值。结果 根据治疗后客观缓解和转化成功情况分别将患者分为缓解组（33例）、未缓解组（47例），转化成功组（33例）、转化失败组（41例）。治疗前，缓解组与未缓解组、转化成功组与未转化成功组血清VEGF、AFP水平比较差异均无统计学意义（P均>0.05）。缓解组治疗后血清VEGF、AFP水平均较治疗前降低（P均<0.05），未缓解组治疗前后血清VEGF、AFP水平比较差异无统计学意义（P均>0.05），缓解组治疗后血清VEGF、AFP水平低于未缓解组（P均<0.05）。转化成功组治疗后血清VEGF、AFP水平均较治疗前降低（P均<0.05），转化失败组治疗前后血清VEGF、AFP水平比较差异无统计学意义（P均>0.05），转化成功组治疗后血清VEGF、AFP水平低于转化失败组（P均<0.05）。治疗后血清VEGF、AFP水平评估晚期肝癌患者客观缓解的曲线下面积为0.870，高于二者单独（0.691、0.742），比较差异均有统计学意义（P均<0.05）。治疗后血清VEGF、AFP水平评估晚期肝癌转化成功的曲线下面积为0.860，高于二者单独（0.695、0.733），比较差异均有统计学意义（P均<0.05）。结论 TACE联合PD-1抑制剂治疗后血清VEGF、AFP水平可反映晚期肝癌患者客观缓解及转化情况。更多还原

【Abstract】 Objective protein(AFP)in evaluating the effect of transcatheter arterial chemoembolization(TACE)combined with programmed death receptor 1(PD-1)inhibitor on advanced liver cancer.Methods selected. All patients received TACE combined with PD-1 inhibitor. Venous blood was collected before and after 2 cycles of treatment to detect serum VEGF and AFP levels. We drew the receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was used to analyze the value of VEGF and AFP in evaluating the objective remission and successful transformation after treatment.Results curred after treatment,patients were divided into the remission group(33 cases)and non-remission group(47 cases),success group(successful transformation,33 cases)and failure group(41 cases). There were no significant differences in serum VEGF or AFP levels before and after treatment between the remission group and non-remission group,and between the success group and failure group(all P>0. 05). The levels of serum VEGF and AFP in the remission group were lower than those before treatment(both P<0. 05). There were no significant differences in serum VEGF or AFP levels before and after treatment in the non-remission group(both P>0. 05). The levels of serum VEGF and AFP in the remission group were lower than those in the non-remission group(both P<0. 05). The levels of serum VEGF and AFP in the success group were lower than those before treatment(both P<0. 05). There were no significant difference in serum VEGF or AFP levels before and after treatment in the failure group(both P>0. 05). The levels of serum VEGF and AFP in the success group were lower than those in the failure group(both P<0. 05). After treatment,the area under the curve of serum VEGF and AFP in evaluating the objective remission after TACE combined with PD-1 inhibitor treatment was 0. 870,which was higher than that of either alone(0. 691 and 0. 742). The difference was statistically significant(P<0. 05). After treatment,the area under the curve of serum VEGF and AFP in evaluating the successful transformation after TACE combined with PD-1 inhibitor treatment was 0. 860,which was higher than that of either alone(0. 695 and 0. 733). The difference was statistically significant(P<0. 05).Conclusion with PD-1 inhibitor treatment can reflect the objective remission and transformation of patients with advanced liver cancer.更多还原