DC Bead载药微球在原发性肝细胞癌患者介入治疗中的应用价值  

Discussion on the application value of DC Bead drug-loaded microspheres in liver cancer based on laboratory indicators and survival rate

作　　者：张嘉诚 杜鹏 蒋富强 张哲 解鹏 王金文 ZHANG Jia-cheng;DU Peng;JIANG Fu-qiang(Interventional treatment group in the department of diagnostic radiology,The sixth Medical Center of the General Hospital of the Chinese people's Liberation Army,(Biejing,100048)China)

机构地区：[1]中国人民解放军总医院第六医学中心放射诊断科介入治疗组,北京100048 [2]中国中医科学院西苑医院老年病科

出　　处：《中西医结合肝病杂志》2022年第8期689-693,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：中国中医科学院第二批中医优势病种临床研究项目(No.CACMS17G008)。

摘　　要：目的:基于患者实验室指标和生存率,探讨DC Bead载药微球在原发性肝细胞癌(HCC)经肝动脉化疗栓塞(TACE)治疗中的应用价值。方法:回顾性分析接受TACE治疗的95例HCC患者资料,根据栓塞剂材料不同分为传统TACE(C-TACE)组和药物洗脱微球TACE(DEB-TACE)组,前者使用传统栓塞剂(碘化油和明胶海绵颗粒),后者使用DC Bead载药微球。检测2组患者术前和术后1个月时血清肿瘤标志物、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、生化指标和外周血淋巴细胞亚群水平,患者随访1年。结果:2组患者术后1个月血清甲胎蛋白(AFP)、异常凝血酶原(PIVKA-Ⅱ)、VEGF和MMP-9水平较术前降低(P<0.05)。术前2组患者血清AFP和PIVKA-Ⅱ水平差异无统计学意义(P>0.05);术后1个月,DEB-TACE组血清AFP、PIVKA-Ⅱ、VEGF和MMP-9水平低于C-TACE组(P<0.05)。2组患者术后1个月血清总胆红素(TBil)、直接胆红素(DBil)、天门冬氨酶氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、血肌酐(SCr)和血尿素氮(BUN)水平较术前差异无统计学意义(P>0.05)。术前和术后1个月,2组患者血清TBil、DBil、AST、ALT、SCr和BUN水平差异无统计学意义(P>0.05)。2组患者术后1个月外周血CD3、CD4和CD4/CD8水平较治疗前升高(P<0.05),CD8水平较治疗前降低(P<0.05)。术前2组患者外周血CD3、CD4、CD8和CD4/CD8水平差异无统计学意义(P>0.05);术后1个月,DEB-TACE组外周血CD3、CD4和CD4/CD8水平高于C-TACE组(P<0.05),CD8水平低于C-TACE组(P<0.05)。DEB-TACE组患者治疗后1年内生存率高于C-TACE组,但二者差异无统计学意义(P>0.05)。结论:DC Bead载药微球比传统栓塞剂在减轻肿瘤负荷、抑制新生血管及改善免疫功能方面更具优势,值得临床推广应用。Objective:To investigate the value of DC Bead drug-loaded microspheres in the treatment of primary liver cancer(HCC)via transcatheter arterial chemoembolization(TACE)based on changes in laboratory indicators and survival rate.Methods:The data of 95 patients with HCC who received TACE in our hospital were retrospectively selected and divided into traditional TACE(C-TACE)group and drug-eluting microsphere TACE(DEB-TACE)group according to the different embolization materials.The former used traditional embolic agents(iodinated oil and gelatin sponge particles),and the latter used DC Bead drug-loaded microspheres.Before treatment and at 1 month after treatment,serum tumor markers,serum vascular endothelial growth factor(VEGF)and matrix metalloproteinase-9(MMP-9),serum biochemical indicators and peripheral blood lymphocyte subsets were detected in the two groups of patients.Follow-up 1 year.Results:The levels of serum alpha-fetoprotein(AFP),abnormal prothrombin(PIVKA-Ⅱ),VEGF and MMP-9 in the two groups were lower than those before surgery P<0.05).There was no significant difference in serum AFP and PIVKA-Ⅱlevels between the two groups before surgery(P>0.05).One month after surgery,serum AFP,PIVKA-Ⅱ,VEGF,and MMP-9 levels in the DEB-TACE group were lower than those in the C-TACE group(P<0.05).There were no statistically significant difference in serum total bilirubin(TBil),direct bilirubin(DBil),aspartate aminotransferase(AST),alanine aminotransferase(ALT),serum creatinine(SCr),and blood urea nitrogen(BUN)levels at 1 month after operation compare with those preoperatively(P>0.05).There was no significant difference in serum TBil,DBil,AST,ALT,SCr and BUN levels between the two groups before and 1 month after operation(P>0.05).The levels of CD3,CD4 and CD4/CD8 in peripheral blood of the two groups were higher than before treatment(P<0.05),and the CD8 level was lower than before treatment(P<0.05).There was no significant difference in the levels of CD3,CD4,CD8 and CD4/CD8 in the peripheral blood of the two groups bef

关 键 词：实验室指标 载药微球 原发性肝癌 临床疗效 

分 类 号：R446.1[医药卫生—诊断学] R735.7[医药卫生—临床医学]