仑伐替尼联合介入化疗栓塞治疗老年原发性肝癌的疗效及对患者血清胰岛素样生长因子Ⅱ、血管内皮生长因子的影响  

Clinical efficacy of lenvatinib combined with transarterial chemoembolization in the treatment of elderly patients with primary hepatocellular carcinoma and its impact on serum insulin-like growth factor-Ⅱand vascular endothelial growth factor levels

作　　者：杜廷伟[1] 原高明[2] 刘鹤阳 陈忠 DU Ting-wei;YUAN Gao-ming;LIU He-yang;CHEN Zhong(Department of Interventional Radiology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,CHINA;Department of Surgery,Department of Critical Care Medicine,Kaiyuan Campus,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,CHINA;Department of Intervention,Luoyang Sixth People's Hospital,Luoyang 471000,Henan,CHINA)

机构地区：[1]河南科技大学第一附属医院开元院区介入科,河南洛阳471000 [2]河南科技大学第一附属医院开元院区重症医学科外科,河南洛阳471000 [3]洛阳市第六人民医院介入科,河南洛阳471000

出　　处：《海南医学》2025年第4期457-462,共6页Hainan Medical Journal

基　　金：河南省医学科技攻关联合共建项目(编号:20231082)。

摘　　要：目的探究仑伐替尼联合介入化疗栓塞(TACE)治疗老年原发性肝癌(PHC)的疗效及对患者血清胰岛素样生长因子Ⅱ(IGF-Ⅱ)、血管内皮生长因子(VEGF)的影响。方法回顾性分析2019年3月至2022年5月于河南科技大学第一附属医院开元院区就诊的73例老年PHC患者的临床诊治资料,根据治疗方式的不同分为对照组(TACE治疗方案)36例和观察组(仑伐替尼联合TACE治疗方案)37例。治疗6周后比较两组患者的临床疗效,以及治疗前1 d及治疗6周后的血清IGF-Ⅱ、VEGF及肝功能指标,同时比较两组患者治疗期间的不良反应发生情况。治疗结束后随访2年,统计两组患者的生存情况。结果治疗后,观察组患者的临床疗效疾病控制率为70.27%,明显高于对照组的44.44%,差异有统计学意义(P<0.05);治疗后,观察组患者的IGF-Ⅱ水平为(506.19±97.39)pg/m L,明显高于对照组的(464.16±71.36)pg/m L,VEGF水平为(250.43±34.16)pg/m L,明显低于对照组的(277.92±41.06)pg/m L,差异均有统计学意义(P<0.05);治疗后,观察组患者的TBIL、ALT、AST水平分别为(16.42±2.04)μmol/L、(41.12±7.65)U/L、(34.69±5.64)U/L,明显低于对照组的(22.69±2.94)μmol/L、(65.94±11.32)U/L、(59.36±7.89)U/L,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为21.62%,略高于对照组的16.67%,但差异无统计学意义(P>0.05);观察组和对照组患者术后6个月内的存活率分别为94.59%、80.56%,差异无统计学意义(P>0.05),但观察组患者术后24个月内存活率为75.68%,明显高于对照组的52.78%,差异有统计学意义(P<0.05)。结论仑伐替尼联合TACE治疗老年PHC患者可有效抑制肿瘤生长,改善肝功能,提高生存率。Objective To explore the efficacy of lenvatinib combined with transarterial chemoembolization(TACE)in the treatment of elderly patients with primary hepatocellular carcinoma(PHC)and its impact on serum insulin-like growth factor-Ⅱ(IGF-Ⅱ)and vascular endothelial growth factor(VEGF)levels.Methods The clinical diagnosis and treatment data from 73 elderly patients with PHC treated at the Kaiyuan Campus,the First Affiliated Hospital of Henan University of Science and Technology between March 2019 and May 2022 were retrospectively analyzed.According to different treatment methods,the patients were divided into a control group(treated with TACE,36 cases)and an observation group(lenvatinib combined with TACE,with 37 cases).After 6 weeks of treatment,the clinical efficacy were compared between the two groups.The serum levels of IGF-Ⅱ,VEGF,and liver function indicators were compared between the two groups one day before treatment and after 6 weeks of treatment.The incidence of adverse reactions during treatment were also compared.After treatment,the patients were followed up for 2 years,and the survival of the two groups of patients were counted.Results The disease control rate in the observation group was 70.27%,signifi-cantly higher than 44.44%in the control group(P<0.05).After treatment,the IGF-Ⅱlevel in the observation group was(506.19±97.39)pg/mL,significantly higher than(464.16±71.36)pg/mL in the control group(P<0.05).VEGF level in the observation group was(250.43±34.16)pg/mL,significantly lower than(277.92±41.06)pg/mL in the control group(P<0.05).After treatment,the levels of total bilirubin(TBIL),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)levels in the observation group were(16.42±2.04)μmol/L,(41.12±7.65)U/L,and(34.69±5.64)U/L,re-spectively,significantly lower than(22.69±2.94)μmol/L,(65.94±11.32)U/L,and(59.36±7.89)U/L in the control group(P<0.05).The overall incidence of adverse reactions in the observation group was 21.62%,as compared with 16.67%in the control group(P>0.05

关 键 词：原发性肝癌 仑伐替尼 化疗栓塞 胰岛素样生长因子 血管内皮细胞生长因子 疗效 

分 类 号：R735.7[医药卫生—肿瘤]