经导管动脉载药微球栓塞与经导管动脉化疗栓塞治疗结直肠癌肝内转移的远期疗效  

Long-term efficacy of drug-eluting beads transcatheter arterial chemoembolization and transcatheter arterial chemoembolization on colorectal cancer with intrahepatic metastasis

作　　者：张景俊[1] 首峰[1] 周永祥[1] 罗志刚[1] 刘贤国 叶世富[1] Zhang Jingjun;Shoufeng;Zhou Yongxiang;Luo Zhigang;Liu Xianguo;Ye Shifu(Department of Oncology,Jianyang People’s Hospital,Jianyang 641400,Sichuan Province,China)

机构地区：[1]简阳市人民医院肿瘤科,四川简阳641400

出　　处：《中国肝脏病杂志（电子版）》2020年第2期76-80,共5页Chinese Journal of Liver Diseases：Electronic Version

基　　金：四川省医学科研青年创新课题(Q17039);四川省成都市医学科研基金项目(2017093)。

摘　　要：目的探讨经导管动脉载药微球栓塞与经导管动脉化疗栓塞治疗结直肠癌肝内转移的疗效。方法选取2017年2月至2019年2月于简阳市人民医院进行治疗的70例结直肠癌肝内转移患者为研究对象,采用随机数表法分为观察组(36例)和对照组(34例),对照组患者采用经导管动脉化疗栓塞,观察组患者采用经导管动脉载药微球栓塞。比较两组患者治疗的总有效率、血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、癌胚抗原(carcinoembryonic antigen,CEA)、生存率及并发症。结果治疗后,观察组总有效率为77.78%(28/36),显著高于对照组的52.94%(18/34),差异有统计学意义(χ^2=4.787,P=0.029)。观察组患者治疗前后VEGF分别为(306.27±80.71)ng/L、(224.15±61.58)ng/L,CEA分别为(19.35±5.42)μg/L、(12.06±3.24)μg/L;对照组患者治疗前后VEGF分别为(307.14±81.72)ng/L、(269.37±68.42)ng/L,CEA分别为(19.84±5.53)μg/L、(16.51±4.36)μg/L,治疗前两组患者血清VEGF和CEA水平差异无统计学意义(P> 0.05);治疗后,两组患者血清VEGF、CEA水平均较治疗前显著降低,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者1年生存率[100.00%(36/36)vs 73.53%(25/34)]和2年生存率[83.33%(30/36)vs 58.82%(20/34)]均显著高于对照组,差异有统计学意义(χ^2值分别为10.935、5.147,P值分别为0.001、0.023)。观察组和对照组不良反应发生率分别30.56%(11/36)、64.76%(21/34),差异有统计学意义(χ^2=6.863,P=0.009)。结论经导管动脉载药微球栓塞治疗结直肠癌肝内转移效果显著,可有效改善患者生存状况,不良反应少,值得推广应用。Objective To investigate the long-term efficacy of drug-eluting beads transcatheter arterial chemoembolization and transcatheter arterial chemoembolization on colorectal cancer with intrahepatic metastasis.Methods Total of 70 colorectal cancer patients with intrahepatic metastasis treated in Jianyang People’s Hospital from February 2017 to February 2019 were selected and divided into observation group(36 cases)and control group(34 cases)according to random number table method.Patients in control group were treated with transcatheter arterial chemoembolization and patients in observation group were treated with drug-eluting beads transcatheter arterial chemoembolization.The clinical efficacy,serum levels of vascular endothelial growth factor(VEGF),cancer embryo antigen(CEA),survival rate and complications were compared between the two groups.Results After treatment,the total efficacy rates of patients in observation group and control group were 77.78%(28/36)and 52.94%(18/34),respectively.The difference was statistically significant(χ2=4.787,P=0.029).VEGF levels of patients in observation group were(306.27±80.71)ng/L and(224.15±61.58)ng/L before and after treatment,respectively.CEA levels of patients in observation group were(19.35±5.42)μg/L and(12.06±3.24)μg/L before and after treatment,respectively.VEGF levels of patients in control group were(307.14±81.72)ng/L and(269.37±68.42)ng/L before and after treatment,respectively.CEA levels of patients in control group were(19.84±5.53)μg/L and(16.51±4.36)μg/L before and after treatment,respectively.There were no significant differences in serum levels of VEGF and CEA between the two groups before treatment(P>0.05).After treatment,the serum VEGF and CEA levels of patients in two groups were significantly lower than those before treatment,which were significantly lower in observation group than those in control group,the differences were statistically significant(all P<0.05).The 1-year[100.00%(36/36)vs 73.53%(25/34)]and 2-year[83.33%(30/36)vs 58.82%(20/34)]s

关 键 词：转移性肝癌 经导管动脉载药微球栓塞 经导管动脉化疗栓塞 血管内皮生长因子 癌胚抗原 疗效 

分 类 号：R735.34[医药卫生—肿瘤]