TACE联合氩氦刀冷冻消融对中晚期肝癌的疗效及对MIF、VEGF、GP73、AFP表达水平的影响  

Effect of TACE combined with cryosurgery on serum MIF,VEGF,GP73 and AFP levels in patients with middle and advanced liver cancer

作　　者：罗斌 洪梅 李波 Luo Bin;Hong Mei;Li Bo(Hepatobiliary Surgery, the Affiliated Hospital of Southwest Medical University, Sichuan Luzhou 646000, China;Department of Interventional Medicine, the Affiliated Hospital of Southwest Medical University, Sichuan Luzhou 646000, China)

机构地区：[1]西南医科大学附属医院肝胆外科,四川泸州646000 [2]西南医科大学附属医院介入医学部,四川泸州646000

出　　处：《现代肿瘤医学》2019年第17期3082-3086,共5页Journal of Modern Oncology

摘　　要：目的:探讨肝动脉化疗栓塞术(TACE)联合氩氦刀冷冻消融治疗中晚期肝癌的效果及对患者血清巨噬细胞移动抑制因子(MIF)、血管内皮细胞生长因子(VEGF)、高尔基体蛋白73(GP73)、甲胎蛋白(AFP)水平的影响。方法:选取我院收治的110例中晚期肝癌患者进行回顾性研究,其中55例患者接受TACE手术治疗(对照组)、另外55例采用TACE+氩氦刀冷冻消融治疗(联合组),两组患者同时给予索拉非尼进行化疗。结果:联合组患者的肿瘤病灶缓解率(78.18%)高于对照组(60.00%),P<0.05;联合组患者的总有效率(92.73%)与对照组(87.27%)比较,差异无统计学意义(P>0.05);治疗后,联合组患者的血清MIF、VEGF、GP73、AFP表达水平显著低于对照组(P<0.05);联合组和对照组患者的恶心呕吐、腹泻、皮疹、发热及尿潴留发生率差异均不具有统计学意义(P>0.05);联合组患者1年、2年生存率分别为54.55%、40.00%,对照组患者为45.45%、25.45%,两组比较差异不具有统计学意义(P>0.05)。联合组的中位生存时间(20.0个月)高于对照组(14.0个月),Log-rank (Mantel-Cox)=5.842,P=0.016。结论:TACE+氩氦刀冷冻消融治疗中晚期肝癌患者有利于进一步减小病灶直径,降低血清MIF、VEGF、GP73、AFP表达水平,但是对患者的远期预后影响不显著。Objective:To investigate the effect of TACE combined with argon helium cryoablation in the treatment of advanced hepatocellular carcinoma and its effects on serum MIF,VEGF,GP73 and AFP levels.Methods:A retrospective study was carried out in 110 patients with middle and advanced liver cancer treated in our hospital,of which 55 patients received TACE surgery(control group),and the other 55 cases were treated with TACE+argon helium cryosurgery(combined group),and the two groups were given Sola Fini chemotherapy at the same time.Results:The remission rate of tumors in the combined group was 78.18% higher than that of the control group(60.00%)(P<0.05).The total effective rate of the combined group was 92.73% compared with the control group of 87.27%(P>0.05).After treatment,serum MIF,VEGF,GP73 and AFP levels were significantly lower in the combined group than in the control group(P<0.05).Differences in the incidence of nausea and vomiting,diarrhea,rash,fever,and urinary retention in the combined and control groups were not statistically significant(P>0.05).The 1-year and 2-year survival rates of the combined group were 54.55% and 40.00%,respectively,and 45.45% and 25.45% in the control group.There was no significant difference between the two groups(P>0.05).The median survival time of the combined group was 20.0 months higher than that of the control group(14.0 months),Log-rank(Mantel-Cox)=5.842,P=0.016.Conclusion:The use of cryoablation with TACE + argon-knife cryoablation to treat patients with advanced hepatocellular carcinoma is beneficial to further reduce the diameter of the lesion and to decrease the levels of serum MIF,VEGF,GP73 and AFP,but it has no significant effect on the long-term prognosis of patients.

关 键 词：肝动脉化疗栓塞术 氩氦刀冷冻消融 中晚期 肝癌 

分 类 号：R730.5[医药卫生—肿瘤] R735.7[医药卫生—临床医学]