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Impact of Camrelizumab Combined with Chemotherapy and Hyperthermic Perfusion on the PD-1/PD-L1 Signaling Pathway in Primary Liver Cancer |
JIANG Lei, LIU Cheng, SUN Wanliang, et al |
The First Affiliated Hospital of Bengbu Medical College, Anhui Bengbu 233400, China |
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Abstract Objective: To explore the mechanism of action of camrelizumab combined with chemotherapy and hyperthermic perfusion in the treatment of primary liver cancer based on the PD-1/PD-L1 signaling pathway. Methods: Eighty patients with advanced primary hepatocellular carcinoma (PHC) treated in the hospital from February 2019 to March 2021 were randomly divided into two groups:a chemotherapy and hyperthermic perfusion group and an apatinib plus chemotherapy and hyperthermic perfusion group,each consisting of 40 patients.The chemotherapy and hyperthermic perfusion group received chemotherapy and hyperthermic perfusion treatment,while the apatinib plus chemotherapy and hyperthermic perfusion group received apatinib plus chemotherapy and hyperthermic perfusion treatment after the initial treatment.Short-term clinical efficacy was compared between the two groups.Flow cytometry was used to assess changes in tumor markers (CEA,AFP,AFP-L3) and T lymphocyte subsets.Liver function indexes (ALT,AST,TBIL,ALP) were compared.PD-1 and PD-L1 expression in peripheral blood were assessed,and the incidence of adverse reactions was compared.Kaplan-Meier survival analysis was conducted during patient follow-up to compare survival rates. Results: In the apatinib plus chemotherapy and hyperthermic perfusion group,short-term clinical efficacy and peripheral blood CD4+,CD8+,and CD4+/CD8+ ratio were higher compared to the chemotherapy and hyperthermic perfusion group.Levels of AFP,AFP-L3,CEA,ALT,AST,TBIL,ALP,PD-1,and PD-L1 expression in peripheral blood were lower in the apatinib combination group (P<0.05).The apatinib combination group had a lower incidence of pain and a higher survival rate compared to the chemotherapy and hyperthermic perfusion group (P<0.05). Conclusion: The combination of camrelizumab and chemotherapy and hyperthermic perfusion can activate T lymphocyte subsets by inhibiting the PD-1/PD-L1 signaling pathway,thereby improving the body's anti-tumor immune function,prolonging the survival period of patients,and reducing pain.This approach is worth promoting in clinical practice.
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