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)

[1] ZHOU WP,YANG Y. Improving the standardized diagnosis level for primary liver cancer[J]. Chin J Dig Surg,2018,17(5):430-432.(in Chinese)周伟平，杨远．提高原发性肝癌的规范化诊断水平[J]．中华消化外科杂志，2018,17(5):430-432.

[2] NAULT JC,SUTTER O,NAHON P,et al. Percutaneous treatment of hepatocellular carcinoma:State of the art and innovations[J]. J Hepatol,2018,68(4):783-797.

[3] ZHAO P,ZHENG JS,ZHANG HH,et al. Efficacy evaluation and exploration of TACE combined with CT-guided precision microwave ablation treatment for primary liver cancer[J]. Chin J Oncol,2016,38(2):138-145.(in Chinese)赵鹏，郑加生，张洪海，等．肝动脉导管化疗栓塞联合CT引导精准微波消融治疗原发性肝癌的疗效及影响因素[J]．中华肿瘤杂志，2016,38(2):138-145.

[4] Bureau of Medical Administration,National Health Commission of the People’s Republic of China. Guidelines for diagnosis and treatment of primary liver cancer in China(2019 edition)[J]. J Clin Hepatol,2020,36(2):277-292.(in Chinese)中华人民共和国国家卫生健康委员会医政医管局．原发性肝癌诊疗规范(2019年版)[J]．临床肝胆病杂志，2020,36(2):277-292.

[5] ZHANG BH,YUE HY. A brief introduction to the evaluation criteria of solid tumor efficacy[J]. J Int Oncol,2016,43(11):845-847.(in Chinese)张百红，岳红云．实体瘤疗效评价标准简介[J]．国际肿瘤学杂志，2016,43(11):845-847.

[6] CHEN W,ZHENG R,BAADE PD,et al. Cancer statistics in China,2015[J]. Ca Cancer J Clin,2016,66(2):115-132.

[7] HERBER S,BIESTERFELD S,FRANZ U,et al. Correlation of multislice CT and histomorphology in HCC following TACE:Predictors of outcome[J]. Cardiovasc Intervent Radiol,2008,31(4):768-777.

[8] ZHANG SL,MA YL. TACE combined with percutaneous microwave ablation in treatment of large primary hepatocellular carcinoma[J]. Chin J Interv Imaging Ther,2013,10(7):397-400.(in Chinese)张世杰，马亦龙．经导管动脉化疗栓塞术联合经皮微波消融治疗大肝癌[J]．中国介入影像与治疗学，2013,10(7):397-400.

[9] GAO YR,CHEN SJ,HOU YW,et al. Clinical effect of Huaier Granule sequential with radiofrequency ablation and TACE in treating primary hepatic carcinoma[J]. J Changchun Univ Chin Med,2020,36(4):684-687.(in Chinese)高远韧，陈思佳，侯英文，等．TACE联合射频消融术序贯槐耳颗粒治疗原发性肝癌[J]．长春中医药大学学报，2020,36(4):684-687.

[10] IEZZI R,POMPILI M,POSA A,et al. Combined locoregional treatment of patients with hepatocellular carcinoma:State of the art[J]. World J Gastroenterol,2016,22(6):1935-1942.

[11] LU Z,WANG YF,TIAN AX. Correlation of serum miR-202 expression with tumor marker levels and oncogene expression in patients with liver cancer[J]. J Hainan Med Univ,2018,24(7):59-62.

[12] HAN Y,WEI DJ. Expression and significance of miR-202,AFP and DKK1 in serum of patients with primary hepatic carcinoma[J]. J Tianjin Med Univ,2018,24(6):517-520.(in Chinese)韩悦，魏殿军．miR-202、AFP及DKK1在原发性肝癌患者血清中的表达及其意义[J]．天津医科大学学报，2018,24(6):517-520.

[13] ZHANG MJ,YAN Q,ZHANG GL,et al. Expression and prognostic role of FHIT,Fibronectin,and PTEN in hepatocellular carcinoma[J]. Clin Lab,2016,62(7):1255-1264.

[14] LEI HW. Expression,significance of FHIT and P16 in HCC tissues and their correlation[D]. Zhengzhou:Zhengzhou University,2015.(in Chinese)雷华文．FHIT、P16蛋白在肝细胞肝癌组织中的表达、相关性及其临床意义[D]．郑州:郑州大学，2015.

[15] ZHANG L,WANG J,XIONG HG. Clinical effect of interventional treatment of hepatic artery perfusion before microwave ablation of liver cancer and its effect on FHIT and P16 protein expression in patients with liver cancer[J]. Chin J Integr Trad West Med Dig,2019,27(1):11-15.(in Chinese)张流，王军，熊华刚．肝癌微波消融前经肝动脉灌注介入治疗的临床效果及对肝癌患者FHIT、P16蛋白表达的影响[J]．中国中西医结合消化杂志，2019,27(1):11-15.

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