射频消融术治疗早期原发性肝癌的近远期疗效及对血清AFP-L3、GP73、AFP、γ-GT的影响  

Short-term and Long-term Therapeutic Effect of Radiofrequency Ablation and Its Influence on Serum AFP-L3,GP73,AFP andγ-GT in Treatment of Early Primary Liver Cancer

作　　者：刘松 王霆[1] 靳剑[1] LIU Song;WANG Ting;JIN Jian(Department of General Surgery,Langfang People′s Hospital,Langfang 065000,China)

机构地区：[1]廊坊市人民医院普外科,河北廊坊065000

出　　处：《医学综述》2021年第16期3309-3313,共5页Medical Recapitulate

摘　　要：目的探究射频消融术治疗早期原发性肝癌的近远期疗效及对血清甲胎蛋白异质体3(AFP-L3)、高尔基体蛋白73(GP73)、甲胎蛋白(AFP)、γ-谷氨酰转移酶(γ-GT)的影响。方法选取2011年10月至2014年10月在廊坊市人民医院经病理学检查确诊并接受手术治疗的早期原发性肝癌患者60例作为研究对象,按照手术方式不同分为研究组和对照组,各30例。研究组患者行射频消融术治疗,对照组行手术切除治疗。观察比较两组患者的临床疗效,手术前后血清AFP-L3、GP73、AFP、γ-GT变化,术后并发症发生率及术后1、3、5年的生存和复发情况。结果研究组总有效率为86.67%(26/30),对照组为80.00%(24/30),两组比较差异无统计学意义(P>0.05)。手术前后血清AFP-L3、GP73、AFP、γ-GT水平的主效应差异有统计学意义(P<0.01),两组间各指标的主效应差异有统计学意义(P<0.01),各指标组间和时点间存在交互作用(P<0.01),术后两组患者血清AFP-L3、GP73、AFP、γ-GT水平均低于术前(P<0.05),研究组低于对照组(P<0.05)。研究组患者术后疼痛、腹腔出血的发生率明显低于对照组[43.33%(13/30)比90.00%(27/30)、0%比20.00%(6/30)](P<0.05),而两组术后感染、发热、胸腔积液的发生率比较差异无统计学意义(P>0.05)。两组术后1、3、5年的生存率和复发率比较差异无统计学意义(P>0.05)。结论射频消融术治疗早期原发性肝癌能尽快纠正患者血清AFP-L3、GP73、AFP、γ-GT水平,且创伤小,术后并发症发生率低。Objective To investigate the short-term and long-term effects of radiofrequency ablation on early primary liver cancer and its effects on serumα-fetoprotein-L3(AFP-L3),Golgi protein 73(GP73),α-fetoprotein(AFP),γ-glutamyltransferase(γ-GT).Methods A total of 60 patients with early primary liver cancer who were confirmed by pathological examination and underwent operation in Langfang People′s Hospital from Oct.2011 to Oct.2014 were included,and divided into a study group and a control group according to different operation methods,30 cases each group.The study group was treated with radiofrequency ablation and the control group was treated with surgical resection.The clinical efficacy,changes of serum AFP-L3,GP73,AFP,γ-GT before and after operation,incidence of postoperative complications,survival and recurrence at 1,3 and 5 years after operation were observed and compared between two groups.Results The total effective rate was 86.67%(26/30)in the study group and 80.00%(24/30)in the control group,there was no significant difference between two groups(P>0.05).There were significant differences in the main effects of serum AFP-L3,GP73,AFP andγ-GT levels before and after surgery(P<0.01),and there were significant differences in the main effects of all indexes between the two groups(P<0.01),and there were interactions in each index between groups and time points(P<0.01).The serum levels of AFP-L3,GP73,AFP andγ-GT in both groups after surgery were lower than those before surgery(P<0.05),and those in the study group were lower than those in the control group(P<0.05).The incidence of postoperative pain and abdominal hemorrhage in the study group was significantly lower than that in the control group[43.33%(13/30)vs 90.00%(27/30),0%vs 20.00%(6/30)](P<0.05),there was no significant difference in the incidence of postoperative infection,fever and pleural effusion between the two groups(P>0.05).There was no significant difference in 1,3 and 5 year postoperative survival rate and recurrence rate between the two groups(

关 键 词：早期原发性肝癌 射频消融术 甲胎蛋白异质体3 高尔基体蛋白73 

分 类 号：R735.7[医药卫生—肿瘤]