P53基因瘤体内注射治疗原发性肝癌的临床研究  

Clinical Study of P53 intratumoral injection in the treatment of Hepatocellular Carcinoma

作　　者：张柏秋[1] 孙义馨[1] 孙鹏[1] 郑昌盛[1] 许吉一[1] 左淑杰[1] 

机构地区：[1]长春市中心医院介入科,吉林130051

出　　处：《当代医学》2009年第23期437-439,共3页Contemporary Medicine

基　　金：吉林省科技厅资金资助项目编号:20050405-6

摘　　要：目的比较p53基因瘤体内注射结合肝动脉化疗栓塞(GTACE)与常规肝动脉化疗栓塞(TACE)治疗中晚期原发性肝癌的近期疗效。方法对不能手术的中晚期肝癌分别采用GTACE(16例)治疗和常规TACE(19例)治疗。GTACE组先经肿瘤供血动脉栓塞直至血管铸型,一周后在彩超引导下经皮经肝穿刺瘤体内多点注射p53基因,每周1次,4次为一个疗程。TACE组经肿瘤供血动脉栓塞直至血管铸型为止。治疗后两组均经保肝及对症处理。疗效观察随访指标卡式评分情况,患者近期生存情况,影像随访及肿瘤缩小程度。结果GTACE组治疗前后卡氏评分组内差异有统计学意义(p<0.05)。患者近期生存状况(两组患者近期生存期比较组内比较差异有统计学意义p<0.05)。影像随访肿瘤大小两组治疗后病灶均有缩小,且组内差异有统计学意义(p<0.05)。结论对于不能手术的中晚期肝癌病人,GTACE与单纯TACE比较在病人生存期,病人生存质量(K氏评分)肿瘤缩小率方面有明显优势。但远期确切疗效还需要大样本、多中心及长时间的随机对照研究来证实。Objective： To compare the p53 gene injection of combined transcatheter arterial chemoembolization （GTACE） and conventional hepatic arterial chemoembolization （TACE） in the treatment of short-term efficacy of the terminal stages of primary liver cancer. Methods： use GTACE （16 cases） and conventional treatment of TACE （19 patients） in treatment to patients who are suffering inoperable advanced liver cancer. Group first GTACE artery embolization by tumor vascular cast until a week after the color Doppler ultrasound-guided percutaneous puncture of liver tumors in vivo by multi-point injection of p53 gene, once a week, 4 times as a course of treatment. Till the TACE artery reach the blood vessels through the blood-supply artery of the embolization of the tumor. Both of the two groups will be dealt with by the liver and illness after treatment. Clinical Observation of follow-up score card indicators, the recent living condition of the patients, imaging follow-up and the degree of the shrinkage of the tumor. Results： the differences within Karnofsky group before and after the GTACE treatement is of statistically significance （p 〈0.05）. The living condition of the patients （the comparison between two groups of patients was of statistically significance p 〈0.05）. After imaging follow-up, the size of tumor lesions of the two groups＇ people have narrowed, and group differences were statistically significant （p 〈0.05）. Conclusions： to the advanced liver cancer patients who cannot suffer the surgery, GTACE compared with TACE alone in patients with survival time, the patient quality of life （K＇s score） to reduce the rate of tumor has a distinct advantage. However, the exact long-term efficacy also requires large samples and long-term multi-center randomized controlled study to prove.

关 键 词：肝癌 P53基因 介入治疗 

分 类 号：R735.7[医药卫生—肿瘤]