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

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.