目的：探讨肝转移对晚期胃癌患者免疫治疗效果的影响。方法：收集2019年2月至2022年1月在南京医科大学附属常州第二人民医院肿瘤中心接受过免疫治疗的晚期胃癌患者的临床资料，进行回顾性分析，利用卡方检验或Fisher确切概率法进行基线特征比较，利用卡方检验和Kaplan-Meier生存分析方法进行有肝转移与无肝转移胃癌患者的疗效和生存期的比较。结果：共有48例晚期胃癌患者纳入分析，根据有无肝转移将患者分为肝转移队列（n=20）和无肝转移队列（n=28）。有肝转移较无肝转移胃癌患者体力状况更差。肝转移队列与无肝转移队列的ORR分别为15.0%和35.7%（P>0.05），DCR分别为65.0%和82.1%（P>0.05）；中位PFS在两组分别为5.0个月和11.2个月（HR=0.40，P<0.05），中位OS分别为12.0个月和19.0个月（P>0.05）。结论：胃癌肝转移患者免疫治疗的疗效差于无肝转移的患者。

Objective: To explore the impact of liver metastasis on immunotherapy efficacy in patients with advanced gastric cancer.Methods: From February 2019 to January 2022, clinical data of patients with advanced gastric cancer who received immunotherapy in the Cancer Center of Changzhou No.2 People's Hospital affiliated to Nanjing Medical University were collected for this retrospective analysis. The baseline characteristics were compared by Chi-square test or Fisher exact probability method. Chi-square test and KaplanMeier survival analysis were used to compare the therapeutic efficacy and survival time between gastric cancer patients with and without liver metastasis. Results: A total of 48 patients with advanced gastric cancer were included in the analysis, and the patients were divided into a liver metastasis cohort (n=20) and a non-liver metastasis cohort (n=28). The physical condition of patients with liver metastasis was worse than those without liver metastasis. The objective response rates (ORR) in metastasis cohort and non-metastasis cohort were 15.0% and 35.7% (P>0.05), respectively; and the disease control rates (DCR) in these two cohorts were 65.0% and 82.1% (P>0.05), respectively. The median progression-free survival (PFS) was 5.0 and 11.2 months in the two groups (HR=0.40, P<0.05), and the median overall survival (OS) was 12.0 and 19.0 months (P>0.05), respectively. Conclusion: The efficacy of immunotherapy in gastric cancer patients with liver metastasis is worse than that in patients without liver metastasis.

常州市卫生健康委员会重大科技项目（No. ZD202113）；常州市卫生健康委员会青年人才科技项目（No. QN202116）；2022常州市第八批科技项目（No. CJ20220086）