槐耳颗粒联合经导管肝动脉化疗栓塞在原发性肝癌伴微血管侵犯根治术后的疗效分析

Analysis of Curative Effect of Huaier Granule Combined with Transcatheter Arterial Chemoembolization Following Radical Resection of Primary Hepatocellular Carcinoma with Microvascular Invasion

目的评估槐耳颗粒联合经导管肝动脉化疗栓塞(TACE)对原发性肝细胞癌伴微血管侵犯病例的术后治疗效果。方法回顾性分析辽宁省肿瘤医院2010年6月至2013年6月期间行肝癌根治术后经病理证实为原发性肝细胞癌同时伴微血管侵犯的45例患者的临床资料。根据手术后的治疗方式将患者分为槐耳颗粒+TACE治疗组(20例)和单纯TACE治疗组(25例)。对2组患者的免疫功能(CD4^+/CD8^+比值和IL-2水平)、术后1、3年肿瘤复发率以及3年生存率进行比较。结果①2组患者术前的CD4^+/CD8^+比值和IL-2水平比较差异均无统计学意义(P>0.05);术后3个月、6个月及12个月时,槐耳颗粒+TACE治疗组的CD4^+/CD8^+比值和IL-2水平均明显高于单纯TACE治疗组(P<0.05)。②随访1年及3年,槐耳颗粒+TACE治疗组复发率分别为15%(3/20)和45%(9/20),分别明显低于单纯TACE治疗组的1年复发率〔48%(12/25)〕及3年复发率〔80%(20/25)〕,差异均有统计学意义(P<0.05)。③槐耳颗粒+TACE治疗组的3年累积生存率为75%,单纯TACE治疗组为68%。生存曲线分析显示,随着时间延长2组患者的3年生存率均下降,槐耳颗粒+TACE治疗组生存率略高于单纯TACE治疗组,但2组间比较差异无统计学意义(P>0.05)。结论虽然在本研究中未能证实原发性肝细胞癌R0术后应用槐耳颗粒+TACE治疗可以明显提高患者的3年生存率,但是槐耳颗粒+TACE治疗能有效降低原发性肝细胞癌伴微血管侵犯患者的术后复发率及提高免疫力,需要扩大研究样本量进一步探索。

Objective To evaluate therapeutical effects of Huaier granule combined with transcatheter arterial chemoembolization （TACE） following radical resection of primary hepatocellular carcinoma with microvascular invasion. Methods The clinical data of 45 cases of primary hepatocellular carcinoma with microvascular invasion underwent Huaier granule combined with transcatheter arterial chemoembolization （TACE） following radical resection from June 2010 to June 2013 in Liaoning Cancer Hospital were retrospectively analyzed. These patients were divided into Huaier granule plus TACE treatment group （20 cases） and simple TACE treatment group （25 cases） according to the postoperative treatment of the patients. The immune function （CD4＋/CD8＊ ratio and IL-2 level）, 1- and 3-year tumor recurrence rates and 3-year cumulative survival rate were compared between two groups after operation. Result （1） The CD4＋/CD8＋ ratio and IL-2 level had no significant differences between the 2 groups before operation （P〉0.05）, which in the Huaier granule plus TACE treatment group were significantly higher than those in the simple TACE treatment group （P〈0.05） on month 3, 6, and 12 after operation. （2） 1- and 3-year tumor recurrence rates in the Huaier granule plus TACE treatment group were significantly lower than those in the simple TACE treatment group [15% （3/20） versus 48% （12/25）, P〈0.05; 45% （9/20） versus 80% （20/25）, P〈0.05]. （3） The 3-year cumulative survival rate was 75% and 68% in the Huaiergranule plus TACE treatment group and the simple TACE treatment group, respectively. The survival curve analysis showed that the 3-year survival rate had a decreased trend, which in the Huaier granule plus TACE treatment group was slightly higher than that in the simple TACE treatment group, but the difference had no statistical significance between the 2 groups （P〉0.05）. Conclusions Although the results of this study fails to confirm that Huaier granule plus TACE treatment for primary hepatocellular carcinoma with microvascular invasion following radical resection could significantly improve the 3-year cumulative survival rate, it could effectively decrease the recurrence rate. It is needed larger sample size to further explore in future research.