超选择性肝肿瘤动脉化疗栓塞术联合热疗治疗原发性肝癌临床观察

发布时间：2018-03-10 07:17

本文选题：原发性肝癌　切入点：超选择性肝肿瘤动脉化疗栓塞术　出处：《临床放射学杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的分析超选择性肝肿瘤供血动脉化疗栓塞术(S-TACE)联合肝区局部高频深部热疗治疗原发性肝癌(HCC)的疗效。方法选取延边大学附属医院2012年1月至2014年2月收治的50例病灶5 cm的原发性HCC患者,分成对照组(A组)和治疗组(B组),每组各25例,A组采用单纯S-TACE治疗,B组采用S-TACE联合肝区高频深部热疗治疗。检测术前和术后不同时间段肝功能、s IL-2R、VEGF、IL-6、COX-2,记录术后不良反应(发热、恶心、呕吐、腹胀、疼痛等)以及KPS评分,并随访生存期。结果与治疗前比较,肝功能指标AST、ALT、TBIL和DBIL在A组患者治疗后第1周明显升高(P0.05),B组治疗后第1周虽有升高,但差异无统计学意义(P0.05);两组术后第4周KPS评分升高,但仅B组有统计学差异(P0.05);两组治疗后第1周和第4周血清VEGF及SIL-2R的含量均下降(P0.05);两组IL-6水平在治疗后第1周和第4周下降(P0.05);A组术后第4周COX-2表达增强(P0.05),B组术后第4周后弱表达,甚至比治疗前更低,无统计学差异(P0.05)。与治疗后第1周比较,两组治疗后第4周IL-6水平均下降(P0.05),治疗后第4周A组血清VEGF和s IL-2R含量升高(P0.05),而B组中两者术后第4周下降(P0.05)。与A组比较,B组术后副反应发生率低(P0.05)。B组的2年生存率较A组高,有统计学差异(P0.05)。结论 S-TACE联合热疗可提高HCC患者KPS评分,降低不良反应,改善生存质量和延长生存期。血清SIL-2R、VEGF、IL-6及组织中COX-2变化可能与HCC患者的治疗效果相关。
[Abstract]:Objective to analyze the efficacy of superselective arterial chemoembolization (S-TACEE) combined with high frequency deep hyperthermia in the treatment of primary hepatocellular carcinoma (HCC). Methods 50 patients with primary liver cancer were selected from January 2012 to February 2014 in the affiliated Hospital of Yanbian University. A case of primary HCC with a focus of 5 cm was found. Each group (25 cases) was treated with S-TACE alone. Group B was treated with S-TACE combined with high frequency deep hyperthermia of liver area. Nausea, vomiting, abdominal distension, pain) and KPS scores, and follow-up survival time. Results compared with pre-treatment, liver function indexes ASTALTBIL and DBIL were significantly higher in group A than those in group A at the first week after treatment. However, the difference was not statistically significant (P 0.05). The KPS score of the two groups increased at the 4th week after operation. However, there was significant difference only in group B (P 0.05); the levels of serum VEGF and SIL-2R decreased in both groups at the 1st and 4th week after treatment. The level of IL-6 in the two groups decreased at the 1st and 4th week after treatment. The expression of COX-2 in group A was enhanced at the 4th week after operation. It was even lower than before treatment, and there was no statistical difference (P 0.05) between the first week and the first week after treatment. The levels of IL-6 decreased in both groups at the 4th week after treatment. The levels of serum VEGF and s IL-2R in group A increased at the 4th week after treatment, while in group B, the levels of VEGF and s IL-2R decreased at the 4th week after operation. Compared with group A, the incidence of postoperative side effects in group B was lower than that in group A. The 2-year survival rate of group B was higher than that of group A. Conclusion S-TACE combined with hyperthermia can improve KPS score, decrease adverse reactions, improve quality of life and prolong survival in patients with HCC. The changes of serum SIL-2RV EGFIL-6 and COX-2 in tissues may be related to the therapeutic effect of HCC patients.
【作者单位】：贵州省黔东南州人民医院肿瘤科;延边大学附属医院肿瘤科;
【基金】：国家自然科学基金委基金项目(编号:81460366-H1617) 吉林省教育厅“十二五”规划项目(2015)
【分类号】：R735.7

【相似文献】