仑伐替尼辅助TACE序贯射频消融治疗乙肝合并晚期肝癌的疗效影响  

Effect of lenvatinib assisted TACE sequential radiofrequency ablation on Hepatitis B complicated with advanced liver cancer

作　　者：张华[1] 贾志阳[1] 高露露 Zhang Hua;Jia Zhi-yang;Gao Lu-lu(Department of Imaging and Nuclear Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院影像与核医学科,河南郑州450052

出　　处：《四川生理科学杂志》2024年第1期40-43,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:研究仑伐替尼辅助肝动脉导管化疗栓塞(Transcatheter arterial chemoembolizstion,TACE)序贯射频消融治疗乙肝合并晚期肝癌的疗效影响。方法:以2019年4月至2022年4月我院收治的66例乙肝合并晚期肝癌患者为研究对象,随机分为对照组和观察组,每组各33例。对照组采用TACE序贯射频消治疗,观察组采用仑伐替尼辅助TACE序贯射频消融治疗。治疗前、治疗6 w后比较两组临床疗效、采用全自动生化分析仪测定丙氨酸转氨酶(Alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(Aspartate aminotransferase,AST)、总胆红素(Total bilirubin,TBIL);以酶联免疫吸附法(Enzyme-linked immunosorbent assay,ELISA)测定碱性成纤维细胞生长因子(Basic fibroblast growth factor,bFGF)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)、血管生成素-2(Angiopoietin-2,Ang-2)、以及放射免疫法测定血清低氧诱导因子1α(Hypoxiainduciblefactor1α,HIF-1α)水平;以采用ELISA测定血清胱氨酸天冬氨酸蛋白酶8(Cysteine-containing aspartate-specific proteases8,Caspase8)、可溶性细胞凋亡因子(Soluble factor-related apoptosis,sFas)水平;比较两组不良反应。结果:观察组临床总有效率81.82%(27/33)高于对照组57.58%(19/33)(P<0.05);与治疗前相比,各治疗组的ALT、AST、TBIL水平均明显降低(P<0.05),其中观察组更为显著(P<0.05);与治疗前相比,各治疗组的血清bFGF、HIF-1α、VEGF、Ang-2水平均明显降低(P<0.05),其中观察组更为显著(P<0.05);与治疗前相比,各治疗组的血清Caspase8水平较高,sFas水平较低(P<0.05),其中观察组更为显著(P<0.05);观察组不良反应总发生率18.18%(6/33)与对照组12.12%(4/33)相比,差异无统计学意义(P>0.05)。结论:仑伐替尼辅助TACE序贯射频消融治疗乙肝合并晚期肝癌患者可进一步提升疗效,改善肝功能,调节血管内皮生长因子及凋亡因子水平,且安全可行。Objective:To study the efficacy of lenvatinib combined with hepatic artery catheter chemoembolization(TACE)sequential radiofrequency ablation in the treatment of advanced hepatocellular carcinoma combined with hepatitis B and its effect on pro-angiogenic factors.Methods:Sixty-six patients with advanced hepatocellular carcinoma combined with hepatitis B admitted to our hospital from April 2019 to April 2022 were studied,and the patients were divided into group B and group A using the random number table method,with 33 patients in each group.Group B was treated with TACE sequential radiofrequency ablation,and group A was treated with lenvatinib combined with TACE sequential radiofrequency ablation.The clinical efficacy,liver function indexes(alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)),serum pro-angiogenic factors(basic fibroblast growth factor(bFGF),hypoxia-inducible factor 1α(HIF-1α),vascular endothelial growth factor(VEGF),angiopoietin-2(Ang-2))levels,serum apoptotic factors(cysteine aspartate protease 8(Caspase8),soluble apoptotic factor(sFas))levels,and adverse reactions before and after 6 weeks of treatment were compared between the two groups.Results:The total clinical effective rate in group A was 81.82%(27/33)higher than that in group B,57.58%(19/33)(P<0.05);the levels of ALT,AST and TBIL in group A were lower than those in group B after 6 weeks of treatment(P<0.05).Serum bFGF,HIF-1α,VEGF,and Ang-2 levels in group A were lower than those in group B after 6 weeks of treatment(P<0.05);serum Caspase8 levels in group A were higher than those in group B and sFas levels were lower than those in group B after 6 weeks of treatment(P<0.05);the overall incidence of adverse reactions in group A was 18.18%(6/33)compared with 12.12%(4/33)in group B.The difference was not statistically significant(P>0.05).Conclusion:Lenvatinib combined with TACE sequential radiofrequency ablation can further enhance the efficacy,improve liver function,and regulate the levels of vascular endothe

关 键 词：仑伐替尼 肝动脉导管化疗栓塞 序贯射频消融 乙肝合并晚期肝癌 

分 类 号：R735.7[医药卫生—肿瘤] R512.62[医药卫生—临床医学]