摘要
目的探究肝癌患者肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)序贯经皮微波消融(microwave ablation,MWA)治疗前后血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)、磷脂酰肌醇蛋白聚糖3(Glypican-3,GPC3)、肿瘤特异性生长因子(tumor specific growth factor,TSGF)水平变化及意义。方法回顾性分析2018年5月至2022年4月郑州大学第一附属医院收治的532例中晚期肝癌患者临床资料,根据治疗方式分为单独TACE组(单独TACE治疗,n=252)及序贯组(TACE序贯MWA治疗,n=280)。比较两组术后疗效及存活率;比较两组手术前后血清VEGF、GPC3、TSGF水平;记录治疗不良反应;分析上述血清学指标对TACE序贯MWA干预疗效的预测价值。结果序贯组术后4周时的ORR及术后6个月时的存活率高于单独TACE组,差异有统计学意义(P<0.05)。序贯组术后的血清VEGF、GPC3、TSGF水平低于单独TACE组,差异有统计学意义(P<0.05)。序贯组术后肝区疼痛、针道出血发生率高于单独TACE组,差异有统计学意义(P<0.05)。序贯组术后4周时,有效亚组术前的血清VEGF、GPC3、TSGF水平低于无效亚组,差异有统计学意义(P<0.05)。血清VEGF、GPC3、TSGF水平单独诊断TACE序贯MWA治疗PLC无效的预测效能低于联合诊断。结论血清VEGF、GPC3、TSGF水平可指导TACE序贯MWA治疗PLC的疗效评估。
Objective To explore the changes and significance of levels of vascular endothelial growth factor(VEGF),Glypican-3(GPC3)and tumor specific growth factor(TSGF)in patients with liver cancer before and after transcatheter arterial chemoembolization(TACE)sequential percutaneous microwave ablation(MWA).Methods The clinical data of 532 patients with advanced liver cancer admitted to the First Affiliated Hospital of Zhengzhou University from May 2018 to April 2022 were retrospectively analyzed,and the patients were divided into simple TACE group(TACE alone,n=252)and sequential group(TACE sequential MWA treatment,n=280)according to treatment methods.The postoperative efficacy,survival rate and serum levels of VEGF,GPC3 and TSGF before and after surgery were compared between the two groups.Adverse reactions of treatment were recorded,and the predictive value of the above serological indicators on efficacy of TACE sequential MWA intervention was analyzed.Results The ORR at 4 weeks after surgery and survival rate at 6 months after surgery in sequential group were higher than those in simple TACE group(P<0.05).Serum levels of VEGF,GPC3 and TSGF after surgery were lower in sequential group than those in simple TACE group(P<0.05).The incidence rates of postoperative hepatic pain and needle-tract bleeding in sequential group were higher compared with those in simple TACE group(P<0.05).The levels of serum VEGF,GPC3 and TSGF in effective subgroup at 4 weeks after surgery were lower than those in ineffective subgroup(P<0.05).The predictive efficiency of serum VEGF,GPC3 and TSGF alone in the diagnosis of ineffectiveness of TACE sequential MWA in PLC was lower than that of combined diagnosis.Conclusion Serum levels of VEGF,GPC3 and TSGF can guide the efficacy evaluation of TACE sequential MWA in the treatment of PLC.
作者
夏俊杰
叶健文
典凤丽
刘文韬
陈昆仑
王雪梅
XIA Jun-jie;YE Jian-wen;DIAN Feng-li;LIU Wen-tao;CHEN Kun-lun;WANG Xue-mei(Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《医药论坛杂志》
2024年第8期840-845,共6页
Journal of Medical Forum
基金
河南省医学科技攻关计划省部共建项目(SBGJ202103071)。
关键词
肝癌
肝动脉化疗栓塞术
序贯经皮微波消融
肿瘤特异性生长因子
Liver cancer
Transcatheter arterial chemoembolization
Sequential percutaneous microwave ablation
Tumor specific growth factor
