经肝动脉化疗栓塞术联合血管内抑制素治疗肝癌的近期疗效及对血清标志物的影响

Short-term efficacy of TACE combined with intravascular inhibin for liver cancer and the effect on serum markers

目的探讨经肝动脉化疗栓塞术(TACE)联合血管内抑制素治疗肝癌的近期疗效,及其对血清基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)和骨桥蛋白(OPN)的影响。方法选取2014年6月至2016年6月间泰州市第二人民医院收治的110例原发性肝癌患者,采用随机数表法分为研究组与对照组,每组55例。研究组患者在TACE治疗基础上联合重组人血管内皮抑制素治疗,对照组患者采用TACE治疗。比较两组患者临床疗效和治疗前后血清MMP-9、VEGF和OPN的变化及不良反应情况。结果研究组患者总有效率为72.7%,高于对照组为50.9%,差异有统计学意义(P<0.05)。研究组患者治疗后血清MMP-9、VEGF和OPN均低于对照组,差异均有统计学意义(均P<0.05)。两组患者胸闷、胃肠道反应、心慌、转氨酶升高、发热和白细胞降低的发生率比较,差异无统计学意义(P>0.05)。结论 TACE联合血管内抑制素治疗肝癌可有效提高临床疗效,通过稳定MMP-9、VEGF和OPN水平抑制了肿瘤细胞活化,安全可靠,适于临床推广。

Objective To study the short-term efficacy of transcatheter arterial chemoembolization（ TACE） combined with intravascular inhibin for liver cancer its effect on the serum levels of matrix metalloproteinase-9（ MMP-9）,vascular endothelial growth factor（ VEGF） and osteopontin（ OPN）. Methods From June 2014 to June 2016,110 patients with primary liver cancer patients who admitted to Second People＇s Hospital of Taizhou were selected. Using a random number table,patients were divided into a study group and a control group with 55 patients in each group. The study group was given TACE combined with recombinant human endostatin and the control group received TACE therapy. The efficacy,changes in MMP-9,VEGF and OPN and adverse reactions were compared between the two groups. Results The overall efficacy rate was 72. 7% for the study group which was higher than 50. 9% of the control group（ P〈0. 05）. After treatment,serum levels of MMP-9,VEGF and OPN were lower in the study group than control group（ all P〈0. 05）. There was no statistically significant difference in the incidence of suppression in chest,gastrointestinal reaction,irregular heart-beat,transaminase elevations,fever and aleukocytosis between the two groups（ P〈0. 05）. Conclusion TACE combined with intravascular inhibin can effectively improve the clinical efficacy for liver cancer and inhibit activation in tumor cell by stabilizing levels of MMP-9,VEGF and OPN,which is safe and reliable and deserve the clinical expansion.