^(125)I粒子植入术联合去甲斑蝥酸钠治疗原发性肝癌疗效观察以及血清VEGF bFGF变化

Treatment of primary hepatocellular carcinoma with iodine 125 particle implantation combined with norcantharidin sodium and the changes of serum VEGF and bFGF

目的:探讨^(125)I粒子植入术联合去甲斑蝥酸钠治疗原发性肝癌的临床疗效以及治疗前后血清VEGF、b FGF表达水平变化。方法:选取枣庄市肿瘤医院2010年6月至2015年6月期间160例原发性肝癌患者,随机分成两组,均行^(125)I粒子植入治疗,其中80例于术后加用去甲斑蝥酸钠静脉滴注14 d,作为观察组;另80例患者术后常规对症支持治疗,作为对照组,随访1~60个月。术后30d、60 d分别检测两组患者各项生化、免疫指标。结果:观察组临床缓解率高,血清b FGF、VEGF、甲胎蛋白(AFP)降低显著,肝功能明显改善,T淋巴细胞亚群CD4、CD8检测指标高于对照组,两组比较差异有统计学意义(P<0.05)。结论:^(125)I粒子植入术联合去甲斑蝥酸钠治疗原发性肝癌,能够显著降低患者血清VEGF、b FGF表达水平,临床疗效显著,值得进一步研究。

Objective： To investigate the clinical efficacy and the changes of serum VEGF and b FGF levels before and after treatment in patients with primary liver cancer treated with iodine 125 seeds implantation combined with sodium norcantharidin. Methods：160 cases of primary liver cancer were randomly divided into two groups,were treated with 125 iodine seed implantation,including 80 cases of postoperative combined with Sodium norcantharidin intravenous infusion of 14 d,as the treatment group;the other80 patients after conventional symptomatic treatment,as the control group was followed up for 1 - 60 months. After 30 and 60 d,the biochemical and immune indexes of the patients in the two groups were detected. Results：The treatment group clinical remission rate,serum vascular endothelial growth factor（vascular endothelial,growth factor,VEGF） and basic fibroblast growth factor（basic fibroblast,growth factor,b FGF）,alpha fetoprotein（AFP） decreased significantly,liver function improved,T lymphocyte subsets CD4,CD8 detection index higher than that of control group. There was significant difference between two groups（P〈0.05）. Conclusion：The treatment of 125 patients with primary liver cancer by iodine particle implantation combined with sodium norcantharidin can significantly reduce the level of serum VEGF,b FGF,and has a significant clinical effect,which is worthy of further study.