仑伐替尼联合TACE治疗中晚期肝癌的疗效及对血清Ki-67、PCNA、GP73、GPC-3水平的影响  

Lenvatinib in combination with transcatheter arterial chemoembolization for treatment of mid-late stage hepatocellular carcinoma:Efficacy and impact on serum Ki-67,PCNA,GP73,and GPC-3 levels

作　　者：胡邵宁 朱书渊 魏燕斌 Shao-Ning Hu;Shu-Yuan Zhu;Yan-Bin Wei(Department of Geriatrics,The Second People’s Hospital of Lishui City,Lishui 323000,Zhejiang Province,China;Department of Gastroenterology,The Second People’s Hospital of Lishui City,Lishui 323000,Zhejiang Province,China)

机构地区：[1]丽水市第二人民医院老年科,浙江省丽水市323000 [2]丽水市第二人民医院消化内科,浙江省丽水市323000

出　　处：《世界华人消化杂志》2023年第11期470-476,共7页World Chinese Journal of Digestology

基　　金：丽水市本级公益性技术应用研究自筹项目,No.2021sjzc050.

摘　　要：背景多数肝癌患者就诊时已进展至中晚期,安全有效的抗肿瘤治疗方式十分重要.肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)可控制肿瘤增殖、侵袭,仑伐替尼有抗血管生成作用,二者联合应用可能对中晚期肝癌治疗效果更佳.目的探究仑伐替尼联合TACE治疗中晚期肝癌的的疗效及对增殖指标细胞增殖核抗原67(proliferating cell nuclear antigen 67,Ki-67)、增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)、浸润转移指标高尔基体蛋白73(golgi protein 73,GP73)、磷脂酰肌醇蛋白聚糖(glypicans-3,GPC-3)水平的影响.方法回顾性选取我院2018-01/2021-05中晚期肝癌患者102例作为研究对象,根据临床病理特征差异给予不同治疗方案,并分组,各51例.对照组采取TACE治疗,观察组采取仑伐替尼联合TACE治疗.比较两组疾病缓解率、治疗前后肿瘤标志物[糖类抗原199(carbohydrate antigen 199,CA199)、甲胎蛋白(alpha-fetoprotein,AFP)]、肝功能指标[谷草转氨酶(aspartate aminotransferase,AST)、谷丙转氨酶(alanine aminotransferase,ALT)、碱性磷酸酶(alkaline phosphatase,ALP)、总胆红素(total bilirubin,TBIL)]、血清Ki-67、PCNA、GP73、GPC-3水平及不良反应.结果观察组疾病缓解率高于对照组(P<0.05);两组治疗2 mo后血清AFP、CA199水平较治疗前下降,观察组低于对照组(P<0.05);治疗2 mo后两组血清Ki-67、PCNA、GP73、GPC-3低于治疗前,观察组低于对照组(P<0.05);治疗2 mo后观察组血清ALT、AST、ALP、TBIL水平与对照组差异无统计学意义;观察组不良反应与对照组无明显差异;随访12 mo,观察组失访1例,对照组失访2例.观察组12 mo生存率高于对照组(P<0.05).结论仑伐替尼联合TACE治疗中晚期肝癌能提高疾病缓解率,降低血清Ki-67、PCNA、GP73、GPC-3、CA199及AFP水平,减轻肿瘤恶性程度,提高生存率,且不增加肝功能损伤风险与药物不良反应.BACKGROUND Most liver cancer patients are diagnosed at mid-late stages,and safe and effective anti-tumor treatment is crucial.Transcatheter arterial chemoembolization(TACE)can control tumor proliferation and invasion,while lenvatinib has anti-angiogenic effects.The combination of the two may have better therapeutic effects on mid-late stage liver cancer.AIM To evaluate the efficacy of lenvatinib in combination with TACE in the treatment of mid-late stage hepatocellular carcinoma and explore their effect on the levels of proliferating cell nuclear antigen 67(Ki-67),proliferating cell nuclear antigen(PCNA),Golgi protein 73(GP73),and glypicans-3(GPC-3),which are indicators of tumor cell proliferation,infiltration,and metastasis.METHODS One hundred and two patients with mid-late stage hepatocellular carcinoma diagnosed at our hospital from January 2018 to May 2021 were retrospectively selected as study subjects and given different treatment regimens according to the differences in clinicopathological characteristics.The patients were divided into either a control group or an observation group,with 51 cases in each group.The control group was treated with TACE and the observation group was treated with lenvatinib combined with TACE.The disease remission rate,tumour markers[carbohydrate antigen 199(CA199)and alpha-fetoprotein(AFP)],liver function indexes[aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),and total bilirubin(TBIL)],serum Ki-67,PCNA,GP73,and GPC-3 levels,and adverse effects were compared between the two groups before and after treatment.RESULTS The disease remission rate in the observation group was significantly higher than that in the control group(P<0.05).Serum AFP and CA199 levels decreased significantly in both groups after 2 mo of treatment compared with those before treatment,and the decrease was more significant in the observation group than in the control group(P<0.05).Serum Ki-67,PCNA,GP73,and GPC-3 were significantly lower in both groups after 2 mo of treat

关 键 词：中晚期肝癌 仑伐替尼 肝动脉化疗栓塞术 疾病缓解率 不良反应 

分 类 号：R735.7[医药卫生—肿瘤]