原发性肝癌立体定向放射治疗效果及对血清AFP和MMP-26水平与生存期影响  

Efficacy of stereotactic radiosurgery in primary liver cancer and its effect on serum AFP,MMP-26 levels and survival

作　　者：刘震寰 雷亚松 唐枭雄 LIU Zhenhuan;LEI Yasong;TANG Xiaoxiong(Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院放射治疗科,河南南阳473000 [2]南阳市中心医院医学检验科,河南南阳473000

出　　处：《社区医学杂志》2023年第18期935-939,共5页Journal Of Community Medicine

摘　　要：目的 探讨立体定向放射治疗(SBRT)对原发性肝癌治疗效果及对血清甲胎蛋白(AFP)、基质金属蛋白酶-26(MMP-26)、生存期的影响。方法 选取2021-02-01-2022-02-01南阳市中心医院收治的90例原发性肝癌患者为研究对象,采用随机数字表法分为观察组和对照组,各45例。对照组给予射频消融(RFA)疗法,观察组给予SBRT治疗。2个月后观察2组治疗效果,记录不良反应发生情况;检测治疗前后血清AFP、MMP-26水平;治疗后随访1年,绘制Kaplan-Meier生存曲线,采用log-rank检验比较2组生存情况。结果 治疗2个月后,观察组治疗总有效率和疾病控制率分别为86.67%和97.78%,对照组分别为80.00%和91.11%,差异无统计学意义,χ^(2)值分别为0.720和1.906,P值分别为0.396和0.167。治疗后观察组血清AFP、MMP-26水平分别为(115.67±28.91) g/mL、(7.83±3.15) ng/L,对照组分别为(201.84±32.58) g/mL、(10.26±4.22) ng/L,2组血清AFP、MMP-26水平均低于治疗前,且观察组低于对照组,F值分别为13.271和3.095,均P<0.001。观察组消化道及全身不良反应发生率分别为22.22%(10/45)和37.77%(17/45),低于对照组的57.78%(26/45)和60.00%(27/45);血液不良反应发生率为80.00%(36/45),高于对照组的53.33%(24/45),差异均有统计学意义,χ^(2)值分别为11.852、4.447和7.200,P值分别为0.001、0.035和0.007。随访1年,观察组死亡2例,对照组死亡3例,差异无统计学意义,χ^(2)=0.212,P=0.645;复发率为6.67%(3/45),低于对照组的22.22%(10/45),χ^(2)=4.406,P=0.036;中位总生存期为(11.40±1.08)个月,大于对照组的(10.01±1.16)个月,差异有统计学意义,t=5.883,P<0.001。结论 SBRT治疗原发性肝癌能有效降低血清AFP、MMP-26水平,提高远期生存率,安全性较高。Objective To investigate the therapeutic effect of stereotactic body radiation therapy(SBRT)on patients with primary liver cancer and its effects on serum alpha-fetoprotein(AFP),matrix metalloproteinnases-26(MMP-26)and sur-vival.Methods A total of 90 patients with primary liver cancer admitted to the Nanyang Central Hospital from February 1,2021 to February 1,2022 were selected as the study subjects.With 45 cases in each group,these patients were divided into observation group and control group by random number table method.The control group was given radiofrequency ablation(RFA)therapy,the observation group was given SBRT treatment,and the treatment effect of the two groups was observed after 2 months of treatment,and the occurrence of adverse reactions was recorded.Serum AFP and MMP-26 levels before and after treatment were detected;After 1 year of follow-up after treatment,Kaplan-Meier survival curves were plotted,and the survival of the two groups was compared by log-rank test.Results After 2 months of treat-ment,the total effective rate and disease control rates of the observation group were 86.67%and 97.78%,respectively,and the total effective rate and disease control rates of the control group were 80.00%and 91.11%,respectively,and there were no significant differences between the two,the x values were 0.720 and 1.906,respectively,the P values were 0.396 and 0.167.After treatment,the serum levels of AFP and MMP-26 in the observation group were(115.67±28.91)g/ml and(7.83±3.15)ng/L,respectively,while those in the control group were(201.84±32.58)g/ml and(10.26±4.22)ng/L.The serum levels of AFP and MMP-26 in both groups were lower than the levels before treatment,and the observation group was lower than the control group.The F values were 13.271 and 3.095,respectively,with P<0.001.The incidence of gastrointestinal reactions and systemic reactions in the observation group were 22.22%(10/45)and 37.77%(17/45),respectively,lower than 57.78%(26/45)and 60.00%(27/45)of the control group;and the incidence of adver

关 键 词：原发性肝癌 立体定向放射治疗 甲胎蛋白 基质金属蛋白酶-26 有效性 生存期 

分 类 号：R735.7[医药卫生—肿瘤]