DEB-TACE序贯射频消融治疗原发性肝癌患者效果研究*

doi:10.3969/j.issn.1672-5069.2023.05.026

摘要/Abstract

摘要： 目的探讨采用药物洗脱微球肝动脉化疗栓塞(DEB-TACE)序贯射频消融(RFA)治疗原发性肝癌(PLC)患者的疗效。方法 2017年11月～2020年11月我院诊治的PLC患者72例,其中接受DEB-TACE治疗38例作为对照组,接受DEB-TACE序贯RFA治疗34例为观察组。采用电化学发光法检测血清甲胎蛋白(AFP)、热休克蛋白90α(HSP90α)、糖类抗原125(CA125)和CA199水平。术后行影像学检查,评估疗效。结果治疗后近期随访,观察组和对照组客观缓解率分别为79.4%和55.3%,差异有统计学意义(P<0.05);观察组血清AFP、HSP90α和CA125水平分别为(123.6±32.5)μg/L、(97.6±21.6)ng/mL和(30.2±13.2)U/mL,均显著低于对照组【分别为(264.5±34.6)μg/L、(129.1±22.3)ng/mL和(71.6±14.3)U/mL,P<0.05】;观察组患者中位总体生存(OS)为28个月,其1 a和2 a生存率分别为88.2%和67.6%,而对照组患者中位OS为20个月,其1 a和2 a生存率分别为71.1%和42.1%,两组差异显著(Log Rank x²=4.258,P=0.039)。结论采用DEB-TACE序贯RFA治疗PLC患者临床疗效确切,可显著延长患者生存时间。

关键词: 原发性肝癌, 药物洗脱微球, 肝动脉化疗栓塞, 射频消融, 治疗, 总体生存率

Abstract: Objective The aim of this study was to observe the efficacy of sequential drug-eluting beads-transcatheter arterial chemoembolization (DEB-TACE) and radiofrequency ablation (RFA) in the treatment of patients with primary liver cancer (PLC). Methods 72 patients with PLC were admitted to our hospital between November 2017 and November 2020, and among them, the DEB-TACE were done in 38 cases as the control, and the sequential DEB-TACE and RFA were carried out in other 34 cases as the observation group. Serum alpha-fetoprotein (AFP), heat shock protein 90α (HSP90α), carbohydrate antigen 125 (CA125) and CA199 levels were detected by electrochemiluminescence. The post-operational efficacy was evaluated by imaging. Results At the end of three month after operation, the Objective remission rate in the observation and control group were 79.4% and 55.3%, significantly different (P<0.05); serum AFP, HSP90α and CA125 levels in the observation group were (123.6±32.5)μg/L, (97.6±21.6)ng/mL and (30.2±13.2)U/mL, all significantly lower than [(264.5±34.6)μg/L, (129.1±22.3)ng/mL and (71.6±14.3)U/mL, respectively, P<0.05] in the control group; the mean overall survival (OS) in the observation group was 28 months, with one-year and two-year survival of 88.2% and 67.6%, while the OS in the control was 20 months, with the one-year and two-year survival of71.1% and 42.1%, significantly different between the two groups (Log Rank x²=4.258, P=0.039). Conclusion The sequential DEB-TACE and RFA in the treatment of patients with PLC has a definite clinical efficacy, which might prolong the survival of patients.

Key words: Hepatoma, Drug-eluting beads, Transcatheter arterial chemoembolization, Radiofrequency ablation, Therapy, Overall survival

陈长广, 肖荣, 王俊. DEB-TACE序贯射频消融治疗原发性肝癌患者效果研究^*[J]. 实用肝脏病杂志, 2023, 26(5): 706-709.

Chen Changguang, Xiao Rong, Wang Jun. Sequential drug-eluting beads-transcatheter arterial chemoembolization and radiofrequency ablation in the treatment of patients with primary liver cancer[J]. Journal of Practical Hepatology, 2023, 26(5): 706-709.

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DEB-TACE序贯射频消融治疗原发性肝癌患者效果研究^*

Sequential drug-eluting beads-transcatheter arterial chemoembolization and radiofrequency ablation in the treatment of patients with primary liver cancer

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