DEB-TACE对比传统TACE治疗不同BCLC分期肝癌的临床疗效分析  

Cli nical efficacy analysis of DEB-TACE compared with traditional TACE in treatment of patients with different BCLC stages of liver cancer

作　　者：侯贺斌[1] 陈鹏[1] 刘平平 盖伟[1] HOU He-bin;CHEN Peng;LIU Ping-ping;GAI Wei(Department of Gastroenterology,Tengzhou Central People's Hospital,Zaozhuang 277500,Shandong,China)

机构地区：[1]滕州市中心人民医院消化内科,山东枣庄277500

出　　处：《生物医学工程与临床》2024年第4期533-539,共7页Biomedical Engineering and Clinical Medicine

摘　　要：目的对比CalliSpheres载药微球经肝动脉化学治疗栓塞术(DEB-TACE)与传统肝动脉化学治疗栓塞术(TACE)治疗不同巴塞罗那临床肝癌(BCLC)分期肝癌的临床疗效。方法选择2018年12月至2020年12月在滕州市中心人民医院收治的102例患者,其中男性75例,女性27例;年龄41~75岁,平均年龄57.85岁;身体质量指数18.2~26.7 kg/m~2,平均身体质量指数22.58 kg/m~2;Child-Pugh分级,A级53例,B级49例;肿瘤直径4~13 cm,平均肿瘤直径8.22 cm;BCLC分期A期52例,B期50例。按照随机数字表法1∶1比例分为观察组和对照组,每组51例。对照组采用传统TACE治疗,观察组采用DEB-TACE治疗,比较两组不同BCLC分期患者临床疗效、治疗前及治疗后3个月肿瘤标志物水平[α-L-岩藻糖苷酶(AFU)、癌胚抗原(CEA)、甲胎蛋白(AFP)]、肝功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]、血清高尔基体蛋白73(GP73)、Dickkopf-1(DKK1)、胸苷激酶1(TK1)水平、并发症发生率及6个月、12个月生存率。结果观察组B期患者疾病控制率(79.17%)较对照组B期(50.00%)高(P<0.05);治疗后3个月,观察组B期患者血清AFP、CEA、AFU、GP73、DKK1、TK1水平较对照组B期患者低[(96.85±8.20)μg/L vs(106.73±7.96)μg/L、(17.57±2.69)μg/L vs(19.93±3.08)μg/L、(48.26±6.48)U/L vs(54.22±8.02)U/L;P<0.05。(89.63±11.25)μg/L vs(98.48±13.26)μg/L、(2.72±0.61)μg/L vs(3.26±0.75)μg/L、(4.27±0.95)pmol/L vs(5.03±1.08)pmol/L;P<0.05];治疗后3个月观察组A期、B期患者血清ALT、AST水平较对照组低[A期:(40.32±9.25)U/L vs(46.86±11.17)U/L、(52.69±7.65)U/L vs(59.78±8.77)U/L;B期:(49.27±10.33)U/L vs(56.75±9.68)U/L、(65.07±10.76)U/L vs(73.15±13.53)U/L。P<0.05];观察组肝功能损伤发生率较对照组低(3.92%vs 17.65%。P<0.05);两组6个月生存率比较,差异无统计学意义(P>0.05),但观察组12个月生存率较对照组高(78.43%vs 58.82%。P<0.05);BCLC分期为A期患者:两组疾病控制率、治疗后3个月血清AFP�Objective To compare the clinical efficacy of CalliSpheres drug-loaded microspheres bead-transcatheter arterial chemoembolization(DEB-TACE)and transcatheter arferial chemoembolization(TACE)in treatment of patients with different stages of Barcelona clinic liver cancer(BCLC).Methods From December 2018 to December 2020,a total of 102 BCLC patients were enrolled,which included 75 males and 27 females,aged 41-75 years old with mean age of 57.85 years old;body mass index(BMI)was 18.2-26.7 kg/m^(2)with mean BMI of 22.58 kg/m^(2).According to Child-Pugh classification,there were 53 cases of grade A and 49 of grade B;the tumor diameter was 4-13 cm with mean tumor diameter of 8.22 cm;52 cases of BCLC stage A and 50 of stage B.According to random number table method,all of them were divided into observation group and control group in ratio of 1:1,with 51 cases in each group.The control group was performed with traditional TACE,and observation group with DEB-TACE.The clinical efficacy,tumor marker levels[α-L-fucosidase(AFU),carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP)],liver function[alanine aminotransferase(ALT),aspartate aminotrans-ferase(AST)],serum Golgi protein 73(GP73),Dickkopf-1(DKK1),thymidine kinase 1(TK1)levels,and incidence of complications before and 3-month after treatment,the 6-month and 12-month survival rate were compared between 2 group with different BCLC stages.Results The disease control rate of stage B patients in observation group(79.17%)was higher than that in control group(50.00%)(P<0.05);at 3-month after treatment,the serum levels of AFP,CEA,AFU,GP73,DKK1 and TK1 in observation group were lower than those in control group[(96.85±8.20)μg/L vs(106.73±7.96)μg/L,(17.57±2.69)μg/L vs(19.93±3.08)μg/L,(48.26±6.48)U/L vs(54.22±8.02)U/L;P<0.05.(89.63±11.25)μg/L vs(98.48±13.26)μg/L,(2.72±0.61)μg/L vs(3.26±0.75)μg/L,(4.27±0.95)pmol/L vs(5.03±1.08)pmol/L.P<0.05];the levels of serum ALT and AST of patients with stage A and B in observation group were lower than those in control group

关 键 词：巴塞罗那临床肝癌分期 CalliSpheres载药微球 肝癌 动脉化学治疗栓塞术 治疗效果 

分 类 号：R735.7[医药卫生—肿瘤]