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摘要：
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摘要：原发性肝癌是目前我国第4位常见恶性肿瘤，其病死率高居我国第2位。由于起病
隐匿，多数中晚期肝癌患者在发现时已丧失了手术切除机会。传统放化疗手段虽疗效确
切，但全身不良反应较大；分子靶向药物虽然较传统治疗具有独到的优势，但存在基因
突变及耐药等问题，在临床应用上仍有一定局限性。随着免疫检查点抑制剂相关临床试
验研究的开展，如抗程序性细胞死亡蛋白1/配体1治疗已被报道对多种类型的实体瘤有
效。但靶向与免疫治疗的结合也对疗效评价提出了新挑战。现报道1例晚期原发性肝癌患
者行仑伐替尼联合信迪利单抗治疗期间，肿瘤存在假性进展的病例，通过动态监测血液
指标及影像学随访下坚持原方案靶向联合免疫治疗策略，使患者获得更好的临床获益。
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Abstract: At present, primary liver cancer is the fourth common malignant tumor in China, and
its fatality rate ranks second in China. Due to the insidious onset, most patients with advanced
liver cancer have lost the opportunity of surgical resection at the time of diagnosis. Although the
traditional radiotherapy and chemotherapy is effective, the systemic adverse effects are obvious.
Molecular targeted drugs have unique advantages over traditional therapy, however, gene mutation
and drug resistance have limited the application in clinical practice. With the development of
immune checkpoint inhibitors therapy and clinical trials, such as anti-programmed cell death protein
1 / ligand 1 (PD-1/PD-L1) therapy, it has been reported to be effective for many types of solid
tumors. However, the combination of targeting and immunotherapy also poses a new challenge
to the evaluation of curative effect. This paper reported a case of pseudoprogression in one patient
with advanced primary liver cancer during the treatment of Lenvatinib combined with Sintilimab.
Through dynamic monitoring of blood indicators and imaging follow-up and adhering to the
original target-free treatment strategy, the patient achieved better clinical benefit.
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