甲苯磺酸索拉非尼联合沙利度胺对原发性肝癌患者高尔基体蛋白73及糖类抗原125的影响

Study on the effect of sorafenib combined with thalidomide on Golgi protein 73 and CA125 in patients with primary liver cancer

目的探讨甲苯磺酸索拉非尼联合沙利度胺对原发性肝癌(PHC)患者高尔基体蛋白73(GP73)及糖类抗原125(CA125)的影响。方法选取临床确诊PHC 64例,按就诊顺序分为对照组与研究组,每组32例。对照组予肝动脉化疗栓塞术(TACE)治疗,甲苯磺酸索拉非尼片400mg/次,2次/d;研究组加用沙利度胺片100~200mg/d,晚睡前口服。检测血清肿瘤相关标志物变化,密切记录治疗期间不良反应,评价近期疗效,并进行为期24个月的随访,记录生存状况。结果与治疗前比较,2组血清甲胎蛋白异质体3(AFP-L3)、GP73、磷脂酰肌醇蛋白聚糖3(GPC-3)、甲胎蛋白(AFP)、癌胚抗原(CEA)、CA125、CA199降低(P=0.000);与对照组比较,研究组AFP-L3、GP73、GPC-3、AFP、CEA、CA125、CA199显著降低(P=0.000),近期疗效客观缓解率(ORR)无差异(P=0.429),随访生存率62%显著提高(P=0.017),但头晕头痛发生率较高(P=0.014)。结论甲苯磺酸索拉非尼联合沙利度胺可提高PHC远期疗效,可显著降低GP73、CA125等肿瘤标志物水平,但也具有头晕头痛发生率高的不足。

Objective To investigate the effect of sorafenib combined with thalidomide on Golgi protein 73 and CA125 in patients with primary liver cancer.Methods Sixty-four cases of primary hepatocellular carcinoma（PHC）were randomly divided into control group and study group,32 cases in each.The control group were treated with transcatheter arterial chemoembolization（TACE）treatment,sorafenib 400 mg,twive a day the study group received more with thalidomide tablets 100-200 mg,one a day.The changes of serum tumor markers were recorded,the adverse reactions during treatment were recorded,the short-term efficacy was evaluated,and the long-term follow-up was conducted for 24 months.The survival status was recorded.Results Compared with before treatment,serum alpha fetoprotein（AFP-L3）,Golgi protein 73（GP73）,glypican 3（GPC-3）,alpha fetoprotein（AFP）, carcinoembryonic antigen（CEA）,cancer antigen 125（CA125）,cancer antigen 199（CA199）of 2 groups decreased（P =0.000）. Compared with the study group,Vlevels of AFP-L3,GP73,VGPC-3 group,VAFP,CEA,CA125 and CA199 were significantly lower（P =0.000）.The curative effect of ORR had no difference（P =0.429）,and the follow-up survival rate was higher（P =0.017）,but the incidence of dizziness and headache rate were higher（P =0.014）.Conclusion Sorafenib combined with thalidomide in the treatment of primary liver cancer can improve the long-term efficacy of PHC,significantly reduce the levels of GP73,CA125 and other tumor markers,but also have a high incidence of dizziness and headache.