TACE联合超声引导下微波消融治疗特殊部位原发性肝癌患者疗效研究*

doi:10.3969/j.issn.1672-5069.2022.03.029

摘要/Abstract

摘要： 目的探讨经导管肝动脉化疗栓塞(TACE)术联合超声引导下微波消融(MWA)治疗特殊部位原发性肝癌(PLC)患者的疗效。方法 2017年11月～2019年11月我院收治的特殊部位PLC患者72例(观察组)和同期收治的常见部位PLC患者60例(对照组),均给予TACE联合超声引导下MWA治疗并随访24 m。采用化学发光法检测血清AFP水平,采用ELISA法检测血清甲胎蛋白异质体L3(AFP-L3)、血管内皮生长因子(VEGF)和S100钙结合蛋白A4(S100A4)水平。结果在治疗后1 m末,观察组疾病控制率为91.7%,与对照组的93.3%比,无统计学差异(P＞0.05);观察组血清AFP、AFP-L3、VEGF和S100A4水平分别为(123.4±13.7)ng/mL、(82.5±10.7)mg/mL、(250.4±46.8)pg/mL和(52.7±13.4)mg/L,与对照组【分别为(120.8±15.6)ng/mL、(80.6±10.1)mg/mL、(248.7±47.3)pg/mL和(50.9±14.5)mg/L】比,无统计学差异(P＞0.05);在治疗后6 m、12 m、18 m和24 m,观察组累积生存率分别为95.8%、88.9%、69.4%和45.8%,与对照组的100.0%、91.7%、73.3%和48.3%比,无统计学差异(P＞0.05)。结论采用TACE联合超声引导下MWA治疗特殊部位的PLC患者也能获得较好的近远期疗效,值得临床进一步验证。

关键词: 原发性肝癌, 经导管肝动脉化疗栓塞术, 微波消融, 甲胎蛋白异质体L3, 血管内皮生长因子, 治疗

Abstract: Objective The aim of this study was to investigate the clinical efficacy of ultrasound-guided microwave ablation (MWA) after transcatheter arterial chemoembolization (TACE)ACE in the treatment of patients with special locations of primary liver cancer (PLC). Methods 72 patients with special locations (adjacent to the top of the diaphragm, gallbladder, gastrointestinal tract, portal vein, hepatic vein, inferior vena cava, right kidney and heart with the shortest distance less than 0.5 cm) of primary liver cancer (observation group) and 60 patients with PLC (control group) were encountered in our hospital between November 2017 and all patients were treated with TACE and thereafter ultrasound-guided MWA combination therapy. The patients were followed-up for 24 months. Serum alpha-fetoprotein (AFP) were detected by chemiluminescence, and serum alpha-fetoprotein heterogeneity L3 (AFP-L3), vascular endothelial growth factor (VEGF) and S100 calcium-binding protein A4 (S100A4) were detected by ELISA. Results At the end of 1 month after treatment, the disease control rate in the observation group was 91.7%, not statistically significantly different as compared to 93.3% in the control (P>0.05); serum AFP, AFP-L3, VEGF and S100A4 levels in the observation group were (123.4±13.7) ng/mL, (82.5±10.7) mg/mL, (250.4±46.8) pg/mL and (52.7±13.4) mg/L, not significantly different as compared to [(120.8±15.6) ng/mL, (80.6±10.1) mg/mL, (248.7±47.3) pg/mL and (50.9±14.5) mg/L, respectively, P>0.05];at 6, 12, 18 and 24 month, the cumulative survival rates in the observation group were 95.8%, 88.9%, 69.4% and 45.8%, not significantly different as compared to 100.0%, 91.7%, 73.3% and 48.3%, respectively, in the control (P>0.05). Conclusion The short-term and long-term efficacy and safety of ultrasound-guided MWA therapy after TACE in the treatment of patients with special locations of liver cancer are similar to those with ordinary liver cancer, which is worthy of clinical verification.

Key words: Hepatoma, Microwave ablation, Transcatheter arterial chemoembolization, Alpha-fetoprotein heterogeneity L3, Vascular endothelial growth factor, Therapy

邱云, 杨玫, 薛红红. TACE联合超声引导下微波消融治疗特殊部位原发性肝癌患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(3): 419-422.

Qiu Yun, Yang Mei, Xue Honghong. Clinical efficacy of ultrasound-guided microwave ablation after TACE in treatment of patients with special locations of primary liver cancer[J]. Journal of Practical Hepatology, 2022, 25(3): 419-422.

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TACE联合超声引导下微波消融治疗特殊部位原发性肝癌患者疗效研究^*

Clinical efficacy of ultrasound-guided microwave ablation after TACE in treatment of patients with special locations of primary liver cancer

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