The Value Of Peripheral Blood M1/M2 Macrophage Ratio In Assessing The Efficacy Of PD-1 Inhibitors In The Treatment Of Advanced Hepatocellular Carcinoma

Objective: In this experiment,healthy people and advanced hepatocellular carcinoma(HCC)patients treated with PD-1 inhibitors were used as the research objects.By detecting the ratio of M1/M2 macrophages in their peripheral blood,we explored whether the ratio of M1/M2 macrophages could help To become a biomarker to assist in the diagnosis of HCC,and to explore whether it can be used as an indicator to predict the efficacy and prognosis of advanced HCC patients treated with PD-1 inhibitors.Methods:(1)Selected patients who were diagnosed with HCC from August2021 to December 2021 and received PD-1 inhibitor(PD-1 inhibitor monotherapy or combination regimen)for the first time in the Department of Medical Oncology,Affiliated Hospital of Guilin Medical College.The basic clinical data of the patients were collected and followed up for 6 months after treatment.After 1 cycle of treatment,the imaging examinations and adverse events were recorded,and the short-term and long-term efficacy evaluations were carried out for the enrolled patients.(2)All patients enrolled in the group drew 5ml of peripheral venous blood in a fasting state within 1 week before administration,collected blood samples using heparin sodium anticoagulant tubes,and stored them at 4°C.Cells were separated and stained within 12 hours after blood collection.The BD FACS Verse flow cytometer was used to detect M1 and M2 macrophages.(3)The enumeration data were expressed by the number of cases and the rate(%),and the chi-square test was used for comparison between groups.Measurement data conforming to normal distribution were expressed as mean ± standard deviation(Mean±SD),and t-test was used for comparison between groups.Survival curves were drawn using the Kaplan-Meier method.The single factor analysis of the influencing factors of treatment efficacy was performed by linear analysis.Statistical significance was established at P<0.05.Results: As of December 31,2021,a total of 16 healthy people and 21 advanced HCC patients were collected,of which 5 patients were excluded because they did not return to the hospital for further treatment,and 16 patients were finally included in the study.Among them,13 were male and 3 were female.The ages ranged from 43 to 78 years old,with a median age of 60 years.Among the evaluable curative effects,0 cases of complete remission(CR),4cases of partial remission(PR),7 cases of stable disease(SD),and 5 cases of progressive disease(PD),DCR was 68.8%,and ORR was 25.0%.The ratio of M1/M2 macrophages in peripheral blood of healthy people was significantly higher than that of HCC patients,and the difference was statistically significant(P<0.001).Survival analysis was performed using the Kaplan-Meier method.The single factor analysis of the influencing factors of treatment efficacy was performed by linear analysis.The 6-month PFS rate in the group was higher than that in the low-value group,but the difference was not statistically significant(P=0.120),suggesting that the increase in M2 macrophages in peripheral blood may not be related to the prognosis of HCC immunotherapy.Conclusions:(1)The ratio of M1/M2 macrophages in peripheral blood of HCC patients was significantly lower than that of healthy people.The ratio of M1/M2 macrophages in peripheral blood may be an auxiliary indicator for the diagnosis of HCC.(2)The ratio of M1/M2 macrophages in peripheral blood of advanced HCC patients treated with PD-1 inhibitor may not be correlated with prognosis.