索拉菲尼与沙利度胺联合对原发性肝癌患者survivin蛋白及CA125的影响

The Effects of Sorafenib Combined with Thalidomide for Treatment of Patients with Primary Liver Cancer in Survivin Protein and CA125

目的探讨索拉菲尼与沙利度胺联合对原发性肝癌(PHC)患者血清survivin蛋白、CA125的影响。方法将2014年4月~2015年6月我院收治的78例不可切除PHC患者分为对照组与研究组,每组39例。两组均给予相同TACE术治疗,对照组予索拉菲尼400 mg/次,2次/d口服;研究组加服沙利度胺100~200 mg·d^(-1),晚睡前口服。均连续治疗12周,并常规实施保肝治疗。检测两组患者血清survivin蛋白、AFP、CEA、CA125、CA199浓度变化,比较近期疗效和安全性,并随访2年,详细记录患者生存状况。结果与治疗前比较,两组患者血清survivin mRNA、survivin蛋白、AFP、CEA、CA125、CA199水平显著下降(P<0.01);研究组血清survivin mRNA、survivin蛋白、AFP、CEA、CA125、CA199水平显著低于对照组(P<0.01),总缓解率、恶心呕吐发生率及2年生存率明显高于对照组(P<0.05)。结论在TACE基础上联合索拉菲尼、沙利度胺治疗PHC效果显著,可提高患者远期生存状况,可能与下调survivin蛋白、CA125表达有关,但也存在恶心呕吐发生率较高等不足之处。

Objective To investigate the effect of sorafenib combined with thalidomide for treatment of primary liver cancer patients and the influence on survivin protein and CA125.Methods78non resectable PHC were selected and divided into the control group and the study group admitted from April2014to May2015,39cases for each group.Patients in both two groups received TACE treatment,the patients in control group received Sola Feeney400mg,bid,the patients in study group received thalidomide100~200mg,qd,the treatment lasted for12weeks.The changes of serum survivin protein,AFP,CEA,CA125,CA199concentrations,the short-term efficacy and safety of patients were compared between the two groups.The survival status was recorded after follow-up of2years.Results Survivin mRNA,serum survivin protein of patients in the two group decreased compared with that before treatment(P<0.01),levels of AFP,CEA,CA125and CA199of patients in the two group decreased compared with that before treatment(P<0.01);survivin mRNA and survivin protein of patients in study group were lower than that in the control group,(P<0.01),the levels of AFP,CEA,CA125,CA199of patients in study group were lower than that in the control group(P<0.01),the total remission rate was higher(P<0.05),and the incidence of nausea and vomiting were higher(P<0.05),and the2-year survival rate was higher(P<0.05)in study group.Conclusion Sorafenib combined with thalidomide for treatment of PHC primary liver cancer patients was effective.It can improve the long-term survival time,which may be related to the down-regulation of survivin protein,and the expression of CA125.However,has the disadvantages of high rate of nausea and vomiting.