经动脉化疗栓塞联合高强度聚焦超声治疗高龄原发性肝癌的临床研究

The Clinical Research of Hepatic Artery Embolism Chemotherapy Combined with High Intensity Focused Ultrasound on Primary Hepatic Cancer in Elderly Patients

目的:研究经动脉化疗栓塞联合高强度聚焦超声治疗高龄原发性肝癌患者的临床效果,为临床治疗提供参考。方法:200例高龄原发性肝癌患者分别进行动脉化疗栓塞术和动脉化疗栓塞术联合高强度聚焦超声治疗,观察患者治疗效果及治疗前后ERK通路相关蛋白分子表达,并与本院同期200例健康体检者进行对照。结果:与动脉栓塞术治疗患者相比,动脉化疗栓塞术联合高强度聚焦超声治疗高龄原发性肝癌患者的Child-Pugh评分明显降低(P<0.05),且生存率明显高于动脉栓塞治疗患者(P<0.05);治疗后患者血清中促凋亡蛋白P53、Caspase6、Caspase9、Laminin(层黏连蛋白)5γ2、E-cadherin(钙粘蛋白)、β-catenin(β链蛋白)、ERK通路蛋白、HIF(缺氧诱导因子)α和COX2(环氧酶2)及基质金属蛋白酶表达明显升高(P<0.05),而C-myc表达明显降低(P<0.05)。结论:经动脉化疗栓塞联合高强度聚焦超声治疗高龄原发性肝癌的效果与其抑制患者体内激活的ERK通路有关。

Objective： To explore the effect of hepatic artery embolism chemotherapy combined with high intensity focused ultrasound on primary hepatic cancer in elderly patients. Methods： 200 cases of elderly primary hepatic cancer patients in our department from Jan 2012 to Dec 2016 were enrolled in this part. The effect and regulation on ERK signaling pathway related proteins were assayed after the medication of hepatic artery embolism chemotherapy combined high intensity focused ultrasound. 200 healthy subjects in our hospital at the same time were taken as control. Results： The results showed that the Child-Pugh scores were decreased greatly（ P 0. 05） while the survival rate were improved（ P 0. 05） after the medication of hepatic artery embolism chemotherapy combined with high intensity focused ultrasound. The results also showed that the proteins including P53,Caspase6,Caspase9,Laminin5γ2,E-cadherin,β-catenin,ERK related proteins,HIFα and COX2 were increased greatly（ P 0. 05）,while the C-myc was decreased significantly（ P 0. 05）. Conclusion： Hepatic artery embolism chemotherapy combined with high intensity focused ultrasound was effective on primary hepatic cancer in elderly patients which maybe related with the regulation of activated ERK pathway.