经肝动脉化疗栓塞术联合微波消融治疗中晚期原发性肝癌的效果分析

李猛; 陆荫英; 董景辉; 皋月娟; 董政; 陈敏; 刘静

doi:10.3969/j.issn.1001-5256.2020.12.016

经肝动脉化疗栓塞术联合微波消融治疗中晚期原发性肝癌的效果分析

DOI: 10.3969/j.issn.1001-5256.2020.12.016

1. 北京大学国际医院超声科
2. 解放军总医院第五医学中心超声科
3. 解放军总医院第五医学中心肝脏肿瘤诊疗中心
4. 解放军总医院第五医学中心放射科

基金项目:

“十三五”国家科技（传染病）重大专项子课题（2018ZX10723204-007-002）；精准医学国家重点专项计划（2017YFC0908401）；

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中图分类号: R735.7
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出版历程
- 收稿日期: 2020-06-29
- 出版日期: 2020-12-20

Clinical effect of transcatheter arterial chemoembolization combined with microwave ablation in treatment of advanced primary liver cancer

Department of Ultrasound,Peking University Hospital
Department of Ultrasound,The Fifth Medical Center of Chinese PLA General Hospital
Comprehensive Liver Cancer Center,The Fifth Medical Center of Chinese PLA General Hospital
Department of Radiology,The Fifth Medical Center of Chinese PLA General Hospital

Research funding:

摘要

摘要:
目的探讨经肝动脉化疗栓塞术（TACE）联合微波消融（MWA）治疗中晚期原发性肝癌的效果和安全性。方法选取2015年4月-2019年6月在解放军总医院第五医学中心接受治疗的186例中晚期原发性肝癌患者,采用随机数字表法分为试验组、对照组各93例。两组患者均行TACE治疗,试验组患者在此基础上给予超声引导下经皮MWA治疗。比较两组患者临床疗效和并发症发生情况。采用荧光定量PCR法检测两组患者血清microRNA-202 （miR-202）水平,采用酶联免疫吸附法检测血清脆性组氨酸三联体（FHIT）和P16蛋白水平,比较上述3种指标治疗前和治疗后3个月的水平变化。计量资料两组间比较采用独立样本t检验;组内治疗前后比较采用配对样本t检验。计数资料两组间比较采用χ2检验。结果试验组患者客观缓解率高于对照组,差异有统计学意义（47. 32%vs 27. 96%,χ2=7. 422,P=0. 006）,疾病控制率比较无明显差异（P> 0. 05）。两组患者治疗后3个月时的血清miR-202、FHIT和P16蛋白水平均较治疗前明显升高（P值均<0. 05）,其中试验组患者治疗后3个月时的血...
- 肝肿瘤 /
- 化学栓塞,治疗性 /
- 导管消融术
Abstract:
Objective To investigate the clinical effect and safety of transcatheter arterial chemoembolization( TACE) combined with microwave ablation( MWA) in the treatment of advanced primary liver cancer. Methods A total of 186 patients with advanced primary liver cancer who were treated in The Fifth Medical Center of Chinese PLA General Hospital from April 2015 to June 2019 were enrolled and divided into study group and control group using a random number table,with 93 patients in each group. Both groups of patients underwent TACE,and the patients in the study group were treated with ultrasound-guided percutaneous MWA. The two groups were compared in terms of clinical outcome and complications. Quantitative real-time PCR was used to measure the serum level of microRNA-202( miR-202),ELISA was used to measure the serum levels of fragile histidine triad( FHIT) and P16 protein,and the changes in the above three indices at3 months after treatment were compared. The two-independent-samples t test was used for comparison of continuous data between two groups,and the paired t-test was used for comparison within one group before and after treatment; The chi-square testwas used for comparison of categorical data between groups. Results The study group had a significantly higher objective response rate than the control group( 47. 32% vs 27. 96%,χ2= 7. 422,P = 0. 006),and there was no significant difference in disease control rate between the two groups( P >0. 05). Both groups had significant increases in the serum levels of miR-202,FHIT,and P16 protein at 3 months after treatment( all P<0. 05),and compared with the control group,the study group had significantly higher serum levels of miR-202( 0. 84 ± 0. 14 vs 0. 58 ±0. 17,t = 11. 385,P < 0. 001),FHIT( 1126. 35 ± 73. 05 pg/ml vs 762. 87 ± 56. 71 pg/ml,t = 37. 904,P < 0. 001),and P16 protein( 52. 86 ± 6. 51 pg/ml vs 39. 06 ± 5. 37 pg/ml,t = 15. 770,P < 0. 001). Conclusion Ultrasound-guided MWA in addition to TACE canimprove the short-term response of patients with advanced primary liver cancer and increase the serum levels of miR-202,FHIT,and P16 protein,with relatively high safety.
- liver neoplasms /
- chemoembolization,therapeutic /
- catheter ablation

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参考文献(15)

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