明胶海绵微粒联合重组人p53腺病毒TACE治疗肝癌疗效分析  

Gelatin sponge microparticle combined with recombinant human adenovirus TACE for the treatment of hepatocellular carcinoma

作　　者：李闯[1] 刘影[1] 周军[1] 

机构地区：[1]大连大学附属中山医院介入科/辽宁省乳腺及消化肿瘤分子标志物高通量筛选机靶向药物转化重点实验室,辽宁大连161001

出　　处：《肝胆胰外科杂志》2017年第6期468-472,共5页Journal of Hepatopancreatobiliary Surgery

基　　金：大连市卫生科学研究计划项目(201316)

摘　　要：目的观察明胶海绵微粒(gelatin sponge particles,GSPs)联合重组人p53腺病毒注射液治疗肝癌的疗效及外周血突变型p53蛋白的变化。方法从2013年1月至2013年12月间入我院行介入治疗的经病理确诊的肝癌患者中选择病例60例,随机分为GSPs+重组人p53腺病毒注射液混合栓塞组、单纯GSPs栓塞组、单纯重组人p53腺病毒注射液灌注组,每组20例。GSPs+重组人p53腺病毒注射液混合栓塞组选用直径350~560μm的GSPs联合重组人p53腺病毒注射液(根据肿瘤大小选取1~4支)混合行肝动脉栓塞术;单纯GSPs栓塞组选用直径350~560μm的GSPs混合行肝动脉栓塞术;将肿瘤供血血管及肿瘤一次性阻断,灌注组应用导管选择进入肿瘤供血责任动脉进行重组人p53腺病毒注射液灌注。观察肿瘤坏死缩小程度及治疗前后外周血突变型p53蛋白的动态变化。结果 GSPs+重组人p53腺病毒注射液混合栓塞组术后1、6、12个月完全缓解率分别为10%、15%、5%,有效率分别为85%、75%、70%,高于单纯GSPs栓塞组(P=0.03)和重组人p53腺病毒注射液单纯灌注组(P=0.01)。GSPs+重组人p53腺病毒注射液混合栓塞组治疗后外周血突变型p53蛋白表达率(治疗前平均23.73%,治疗后平均12.01%)显著下降,差异有统计学意义(P<0.01);单纯GSPs栓塞组和重组人p53腺病毒注射液单纯灌注组治疗前后外周血突变型p53蛋白表达率比较差异无统计学意义(P>0.05)。结论应用GSPs联合重组人p53腺病毒注射液治疗肝癌肿瘤坏死效果明显,外周血突变型p53蛋白表达率显著下降,为肝癌患者提供了一种较好的治疗方案。Objective To study the curative effect of gelatin sponge particles （GSPs） combined with recombinanthuman p53 adenovirus injection on hepatocellular carcinoma and the changes of p53 protein in peripheralblood. Methods A total of 60 hepatocellular carcinoma patients admitted in Affiliated Zhongshan Hospital ofDalian University between Jan. 2013 and Dec. 2013 were collected inthis study. Patients were randomly dividedinto 3 groups GSPs＋recombinant human adenovirus injection group, simple GSPs embolization group, andsimple recombinant human p53 adenovirus injection group, 20 patients in each group. GSPs＋recombinant humanp53 adenovirus injection mixed embolization group with diameter of 350~560 μm GSPs combined with recombinanthuman p53 adenovirus injection, and then underwent mixed hepatic artery embolization; simple GSPs embolizationgroup with diameter of 350~560 μm GSPs, and then mixed for with hepatic arterial embolization; tumorblood vessels and tumor were blocked once, and perfusion group was treated with catheter to enter the tumorblood supply responsibility artery for recombinant human adenovirus injection. The dynamic changes of tumornecrosis and shrinkage and the changes of p53 protein in peripheral blood were observed. Results The completeremission rate of GSPs＋recombinant human p53 adenovirus injection embolization group was 10%, 15% and 5% after 1, 6 and 12 months respectively, and the effective rates were 85%, 75% and 70%, which were significantlyhigher than those in simple GSPs embolization group （P=0.03） and simple recombinant human adenovirusinjection group （P=0.01）; but the expression rate of p53 protein was significantly decreased （23.73% for beforetreatment, 12.01% for after treatment, P〈0.01）. There was no significant difference in the expression rate of p53protein between the simple GSPs embolization group and the simple recombinant human adenovirus injectiongroup before and after treatment. Conclusion GSPs combined with recombinant human p53 adenovirus injectionfor the

关 键 词：明胶海绵微粒 p53腺病毒注射液 肝动脉化疗栓塞术(TACE) 肝癌 

分 类 号：R735.7[医药卫生—肿瘤]