循环热灌注化疗联合替吉奥治疗肝癌腹腔积液临床评价

Clinical Evaluation on Circulatory Hyperthermic Perfusion Chemotherapy Combined with Tegafur,Gimeracil and Oteracil Potassium Capsules in the Treatment of Hepatocellular Carcinoma with Peritoneal Effusion

目的探讨循环热灌注化学治疗(简称化疗)联合替吉奥治疗肝癌腹腔积液的临床疗效及对可溶性程序性死亡蛋白1(s PD-1)、可溶性程序性死亡配体-1(s PD-L1)、癌胚抗原(CEA)及甲胎蛋白(AFP)的影响。方法选取医院2017年1月至2018年1月收治的肝癌腹腔积液患者72例,按治疗方法的不同分为对照组和试验组,各36例。两组患者均予循环热灌注化疗,每周1次,共治疗4次;试验组患者加服替吉奥胶囊,每次1粒,每日2次,均持续治疗28 d。结果试验组总有效率为94.44%,显著高于对照组的72.22%(χ^2=5.258,P=0.022<0.05);与治疗前比较,两组患者治疗后的s PD-1,s PD-L1,CEA,AFP水平均显著降低(P<0.05),且试验组上述指标显著低于对照组(P<0.05);两组患者恶心呕吐、白细胞下降、血红蛋白下降、肝肾功能受损及心电图异常发生率相当(P>0.05)。结论循环热灌注化疗联合替吉奥治疗肝癌腹腔积液可有效降低s PD-1,s PD-L1,CEA,AFP水平,提升疗效。

Objective To investigate the clinical efficacy of circulatory hyperthermic perfusion chemotherapy combined with Tegafur,Gimeracil and Oteracil Potassium Capsules in the treatment of hepatocellular carcinoma with peritoneal effusion and its effect on soluble programmed death protein-1(sPD-1),soluble programmed death ligand-1(sPD-L1),carcinoembryonic antigen(CEA) and alpha-fetoprotein(AFP).Methods Totally 72 patients with hepatocellular carcinoma with peritoneal effusion admitted to our hospital from January 2017 to January 2018 were selected and divided into the control group and the experimental group according to different treatment methods,36 cases in each group.The patients in the two groups were given circulatory hyperthermic perfusion chemotherapy,once a week,a total of four times.On this basis,the patients in the experimental group were given Tegafur,Gimeracil and Oteracil Potassium Capsules,1 capsule each time,twice a day.Both groups were treated for 28 d.Results The total effective rate of the experimental group was 94.44%,which was significantly higher than 72.22% of the control group(χ^2= 5.258,P=0.022 0.05).Compared with those before treatment,the levels of s PD-1,s PD-L1,CEA and AFP in the two groups were significantly lower after treatment,and the above indexes in the experimental group were significantly lower than those in the control group(P<0.05).The incidence of nausea and vomiting,leukopenia,decrease of hemoglobin,damage of liver and kidney function and abnormal electrocardiogram(ECG)were similar between the two groups(P>0.05).Conclusion Circulatory hyperthermic perfusion chemotherapy combined with Tegafur,Gimeracil and Oteracil Potassium Capsules in the treatment of hepatocellular carcinoma with peritoneal effusion can effectively reduce the levels of s PD-1,s PD-L1,CEA and AFP,it also can improve the clinical efficacy.