肝脏肿瘤动脉灌注化疗栓塞术联合重组人肿瘤坏死因子治疗肝脏肿瘤

TACE combined with rhTNF in the treatment of HCC

目的观察肿瘤坏死因子（TNF）联合肝脏肿瘤动脉灌注化疗栓塞术（TACE）治疗肝脏肿瘤的疗效以及对外周TNF—β的mRNA的表达影响。方法将肝细胞癌（HCC）患者分为2组，单纯TACE治疗者48例为对照组，联合重组人TNF治疗者30例为实验组。通过肝脏增强CT测量比较肿瘤体积大小。应用逆转录-聚合酶链反应（RT—PCR）检测血液中TNF—β的mRNA的表达，半定量比较两组之间TNF—β表达水平的高低。结果术前两组之间肿瘤体积大小和TNF-β的mRNA表达水平差异均无统计学意义（P〉0．05），术后30d实验组肿瘤体积（18．44±3．46）明显小于对照组（23．36±4．11），差异有统计学意义（P〈0．05）实验组血液中TNF—β的mRNA的表达（0．58-t-O．18）明显高于对照组（0．47±0．14），差异均有统计学意义（P〈0．05）。60d时两组间TNF—β的mRNA表达差异无统计学意义（P〉0．05）。结论TNF联合TACE对HCC疗效好于单一TACE治疗，其同时可以刺激外周TNF-β的表达发挥更好的抗肿瘤作用。

Objective To evaluate the efficacy of TACE combined with TNF-β in the treatment of HCC and its effects on the expression of TNF-β mRNA. Methods The HCC patients were divided into TACE ＋ TNF-β group （group A） and TACE group （group B）. The tumor size was measured by SCT. The expression of TNF-β mRNA was detected by RT-PCR in all cases of HCC, and the PCR products were tested by gel electrophoresis. The expression of TNF-β mRNA was semi-quantified by calculating the ratio of the gray value of bands. Results The tumor size and the expression of TNF-β mRNA had no statistically significant difference before operation between two groups （ P 〉 0. 05 ）. On the 30th day after operation, the tumor size in groups A was （ 18.44± 3.46 ）, significantly less than in group B （ 23.36 ±4. 11, P 〈 0.05 ） ; The expression of TNF-β mRNA in group A was （ 0.58 ± 0.18 ） , significantly higher than in group B （0.47±0.14, P 〈 0.05 ）. On the postoperative day 60, there was no significant difference in the expression of TNF-β mRNA between two groups （P 〉0. 05）. Conclusion The curative effectiveness of TACE combined with TNF-β in the treatment of HCC is better than TACE alone, and TACE combined with TNF- β can exert anti-tumor effects by inducing the expression of TNF-β.