TACE联合131 I美妥昔单克隆抗体灌注治疗原发性肝癌患者近期疗效研究  

Short-term efficacy oftranscatheter arterial chemoembolization with 131 I methicone monoclonal antibody in the treatment of patients with primary liver cancer

作　　者：郭文成[1] 李娜[2] 王芳[1] 张宁 刘燕 Guo Wencheng;Li Na;Wang Fang(Department of Gastroenterology,Second Hospital,Yulin 719000,Shaanxi Province,China)

机构地区：[1]陕西省榆林市第二医院消化内科,719000 [2]西安交通大学第二附属医院检验科 [3]西安市长安区中医医院消化内科

出　　处：《实用肝脏病杂志》2020年第6期877-880,共4页Journal of Practical Hepatology

摘　　要：目的探讨经肝动脉栓塞化疗(TACE)介入术时加入131 I美妥昔单克隆抗体灌注治疗原发性肝癌患者的近期疗效及影响预后的因素。方法2016年8月~2017年12月我院治疗的原发性肝癌患者84例,被分成对照组42例和观察组42例,分别给予TACE介入术治疗和在TCACE术灌注化疗药物后继续给予131Ⅰ美妥昔单克隆抗体灌注。术后随访12个月,采用多元Logistics回归分析影响患者预后的危险因素。结果在治疗后3个月,观察组疾病缓解率和疾病控制率分别为73.8%和90.5%,显著高于对照组的50.0%和73.8%(P<0.05);观察组不良反应发生率为28.6%,与对照组的33.3%比,差异无统计学意义(P<0.05);术后,观察组血清甲胎蛋白水平为(418.7±67.3)ng/ml,显著低于对照组[(504.7±71.5)ng/ml,P<0.05],而血清白蛋白水平为(37.7±3.4)g/L,显著高于对照组[(34.2±3.3)g/L,P<0.05];在治疗后12个月,观察组死亡7例(16.7%),对照组死亡12例(28.6%,P<0.05);经多元Logistics回归分析,存在门静脉癌栓、肿瘤直径>5 cm和TNM分期Ⅳ期是导致患者出现不良预后的危险因素(OR=2.354,P=0.027;OR=2.670,P=0.011;OR=3.071,P=0.004)。结论在采用TACE治疗原发性肝癌患者时,加入131 I美妥昔单克隆抗体灌注有助于提高近期疗效,但对存在门静脉癌栓、肿瘤直径>5 cm和TNM分期较晚的患者,治疗效果仍较差。Objective To explore the short-term curative effect of transcatheter arterial chemoembolization(TACE)with 131 I mentuximab perfusion in the treatment of patients with primary liver cancer(PLC)and influencing factors of prognosis.Methods Eighty-four patients with PLC were admitted to our hospital from August 2016 through December 2017,and were divided into control group and observation group,with 42 cases in each group.The patients with PLC in the control group were treated with TACE,and those in the observation received TACE and 131 I mentuximab perfusion.All patients were followed-up for 12 months.The risk factors affecting prognosis were analyzed by multivariate Logistics regression analysis.Results At the end of three months,the remission rate and control rate in the observation group were 73.8%and 90.5%,significantly higher than 50.0%and 73.8%,respectively,in the control(P<0.05);the incidence of side effects was 28.6%in the observation group,not significantly different compared to 33.3%in the control group(P>0.05);serum alpha-fetoprotein level in the observation group was(418.7±67.3)ng/ml,much lower than[(504.7±71.5)ng/ml,P<0.05]in the control,and serum albumin level was(37.7±3.4)g/L,significantly higher than[(34.2±3.3)g/L,P<0.05]in the control;at the end of 12 month,seven patients(16.7%)in the observation died,while twelve patients(28.6%)in the control died(P<0.05);the multivariate Logistics regression analysis showed that the portal vein tumor thrombus,tumor diameter greater than 5 cm and advanced stage of TNM were the risk factors of poor prognosis(OR=2.354,P=0.027;OR=2.670,P=0.011;OR=3.071,P=0.004).Conclusion The short-term curative effect of TACE with 131 I mentuximab perfusion in the treatment of patients with PLC is promising,and some factors such as portal vein tumor thrombus,large tumor diameter and advanced TNM staging might hint poor prognosis.

关 键 词：原发性肝癌 经肝动脉栓塞化疗 131 I美妥昔单克隆抗体 预后影响因素 

分 类 号：R735.7[医药卫生—肿瘤]