中国实用外科杂志2024，Vol.44Issue(9)：1055-1061,7.DOI:10.19538/j.cjps.issn1005-2208.2024.09.15
免疫治疗对早中期肝细胞癌局部治疗后5年生存率的影响研究:基于安徽省肝胆外科联盟肝癌临床-生物样本库
A study of the effect of immunotherapy on 5-year survival in locally treated early and middle stage hepatocellular carcinoma——based on the Liver Cancer Clin-Bio Databank of Anhui Hepatobiliary Surgery Union(LCCBD_AHSU)
摘要
Abstract
Objective To investigate the effect of immunotherapy on the 5-year survival in locally treated early and middle-stage hepatocellular carcinoma undergoing local treatment.Methods Clinical data of 2609 patients with early and middle-stage hepatocellular carcinoma treated with local therapy admitted to 22 centers from the Liver Cancer Clin-Bio Databank of Anhui Hepatobiliary Surgery Union(LCCBD_AHSU)from October 2010 to February 2024 were retrospectively analyzed.Propensity score matching(PSM)was used according to 1∶1 nearest neighbor matching method,and there were 236 patients in each group of immunotherapy and non-immunotherapy after matching.Overall survival(OS)was compared between the two groups,and the risk factors of OS were analyzed by the Cox regression model.Results(1)Before PSM,OS was longer in the immunotherapy group compared with the non-immunotherapy group(P＜0.001);after matching the PSM,the OS of patients in the immunotherapy group was still longer(P＜0.001).(2)After matching the PSM,the results of the univariate analysis showed that cirrhosis(HR=0.45,95％CI0.31-0.65,P＜0.001),radical surgical resection(HR=0.23,95％CI 0.16-0.34,P＜0.001),immunotherapy after recurrence(HR=0.59,95％CI 0.40-0.89,P=0.011)were the protective factors for the OS of patients,while Child-Pugh class B(HR=2.43,95％CI 1.48-3.98,P＜0.001),the maximum tumor diameter ≥5 cm(HR=1.92,95％CI 1.32-2.82,P＜0.001)and alpha-fetoprotein(AFP)≥400 µg/L(HR=1.52,95％CI 1.06-2.17,P=0.023)were the risk factors for the OS of patients.The results of the multivariate analysis showed that antiviral therapy(HR=0.62,95％CI0.39-0.99,P=0.044),radical surgical resection(HR=0.33,95％CI 0.21-0.51,P＜0.001)and immunotherapy after recurrence(HR=0.64,95％CI 0.42-0.96,P=0.031),immunotherapy after recurrence(without perioperative immunotherapy)(HR=0.22,95％CI 0.08-0.62,P=0.004)were the independent protective factors affecting the OS of patients.Conclusion Compared with local therapy alone,immunotherapy may provide survival benefits and prolong the OS of patients with early and middle-stage hepatocellular carcinoma undergoing local treatment.关键词
免疫治疗/肝细胞癌/预后/数据库Key words
immunotherapy/hepatocellular carcinoma/prognosis/databank分类
医药卫生引用本文复制引用
王永帅,王继洲,张峰,张珅瑜,宋瑞鹏,蔡伟,张树庚,王嘉倍,尹大龙,刘连新..免疫治疗对早中期肝细胞癌局部治疗后5年生存率的影响研究:基于安徽省肝胆外科联盟肝癌临床-生物样本库[J].中国实用外科杂志,2024,44(9):1055-1061,7.基金项目
科技部国家重点研发计划项目(No.2019YFA0709300) （No.2019YFA0709300）
国家自然科学基金面上项目(No.82170618,No.82373232) （No.82170618,No.82373232）
安徽省重点研究与开发计划项目(No.202204295107020025) （No.202204295107020025）
中国科学技术大学附属第一医院创新攻关团队项目(No.CXGGO1) （No.CXGGO1）
