TACE联合索拉菲尼治疗原发性肝癌的疗效观察及血清VEGF、bFGF水平的变化

The efficacy and serum VEGF,bFGF changes of TACE combined with Sorafenib in the treatment primary liver cancer

目的：探讨肝动脉化疗栓塞术（TACE）联合索拉非尼治疗原发性肝癌的疗效及安全性，并应用酶联免疫吸附测定法（enzyme-linked immunosorbent assay，ELISA）检测原发性肝癌患者治疗前、后血清血管内皮生长因子（vascular endothelial growthfactor，VEGF）和碱性成纤维细胞生长因子（basic fibroblast growthfactor，bFGF）水平的变化。方法：随机选择48例确诊的原发性肝癌患者，按照单纯随机抽样法均分为TACE联合索拉非尼治疗组和单纯TACE治疗组。4～6周进行复查、评价疗效及安全性。采用ELISA检测TACE联合索拉非尼和单纯TACE治疗前1天、后7天、后28天血清VEGF、bFGF浓度的改变，同时分析VEGF与bFGF浓度的相关性。结果：TACE联合索拉非尼治疗组RR、DCR均高于单纯行TACE治疗组，差异有统计学意义（P〈0．05）；治疗后28天两组患者血清VEGF、bFGF的浓度均较治疗前降低，但TACE联合索拉非尼治疗组较单纯行TACE治疗组下降明显（P〈0．05）。结论：TACE联合索拉非尼较单纯TACE治疗能够提高中晚期原发性肝癌患者的有效率及疾病控制率，并且毒副反应可以耐受，安全性较好；TACE联合索拉非尼较单纯TACE治疗能够更好地降低原发性肝癌患者血清VEGF和bFGF的表达水平。

Objective：To stndy the effect of TACE combined with sorafenib in the treatment of primary liver canc- er, and enzyme - linked immunosorbent assay （ELISA） was ased to detect primary liver cancer patients before and af- ter treatment, serum vascular endothelial growth factor （VEGF） ,basic fibroblast growth factor （bFGF）level changes. Methods：Randomly selectld 48 cases diagnosed with primary liver cancer, divided into TACE combined with sor- afenib treatment group and the TACE group. Using Enzyme - linked immunosorbent assay （ELISA） to detect serum VEGF, bFGF. Results ：TACE combined with sorafenib group RR, DCR were higher than TACE treatment group, the difference was statistically significant （ P 〈 0. 05 ）. 28 days post - treatment serum VEGF groups compared with pre - treatment concentration of bFGF decreased, but TACE combined with sorafenib group than a simple line TACE treat- ment group decreased significantly （ P 〈 0. 05 ）. Conclusion ： TACE combined with sorafenib compared with TACE a- lone can improve the efficiency and disease control rate, and toxicity can be tolerated, and the security is better, reduce the serum levels of VEGF and bFGF expression in liver cancer patients.