腹腔镜下射频消融联合静脉化疗对肝癌患者血清肿瘤标志物甲胎蛋白、细胞角蛋白19、父系表达基因10表达的影响

Effect of laparoscopic radiofrequency ablation combined with intravenous chemotherapy on expressions of serum tumor markers AFP,CK19 and PEG10 in patients with hepatocellular carcinoma

目的探讨腹腔镜下射频消融联合静脉化疗对肝癌患者血清肿瘤标志物甲胎蛋白(AFP)、细胞角蛋白19(CK19)、父系表达基因10(PEG10)表达的影响。方法选取原发性肝癌患者86例,随机分为对照组43例,予临床常规静脉化疗治疗;实验组43例,在对照组静脉化疗的基础上联合应用腹腔镜下射频消融治疗。观察2组患者治疗前后血清肿瘤标志物AFP、CK19、PEG10、肿瘤组织相关基因mRNA表达量,以及治疗后4个月复发率及生存时间水平变化。结果与治疗前相比,治疗后2组患者的血清AFP、CK19、PEG10水平均比治疗前明显降低;与对照组比较,实验组患者治疗后血清AFP、CK19、PEG10水平、HIF-1、VEGF mRNA、β-catenin、Cyclin D1、c-myc及MMP-7 mRNA表达量水平均低于对照组,PTEN mRNA表达量水平高于对照组;实验组中位生存期(28.3个月)显著高于对照组(13.7个月),上述差异均有统计学意义(P<0.05)。结论腹腔镜下射频消融联合静脉化疗能有效降低肝癌患者血清肿瘤标志物AFP、CK19、PEG10水平,通过PTEN通路、Wnt通路抑制肝癌细胞生长,延长生存时间。

Objective To investigate the effect of laparoscopic radiofrequency ablation combined with intravenous chemotherapy on the expression of serum tumor markers AFP,CK19 and PEG10 in patients with hepatocellular carcinoma.Methods Totally 86 patients diagnosed as primary liver cancer were selected and randomly divided into two groups,and 43 cases in the control group was treated with routine intravenous chemotherapy,and 43 cases in the experimental group were treated with laparoscopic radiofrequency ablation on the basis of the control group.The serum tumor markers AFP,CK19,PEG10,the expression of tumor related gene mRNA in both groups were observed before and after treatment,and the recurrence rate and survival time of the patients at the 4 months after treatment were observed.Results Compared with before treatment,the serum levels of AFP,CK19 and PEG10 in the two groups after treatment were significantly lower than those before treatment.Compared with the control group,serum AFP,CK19,PEG10,HIF-1,mRNA,VEGF levels of-catenin,CyclinD1,c-myc and beta MMP-7mRNA expression levels in the experimental group after treatment were lower than the control group,PTEN mRNA expression level was higher than the control group.The median survival time （2 8.3 months） in the experimental group was higher than that in the control group （13.7 months）.All of these results had significant differences （P ＜ 0.05）.Conclusion Laparoscopic radiofrequency ablation combined with intravenous chemotherapy can effectively reduce markers AFP,CK19,PEG10 in patients with hepatocellular carcinoma,and inhibit growth of hepatocellular carcinoma cells through PTEN,Wnt pathway,and prolong the survival time.