摘要
目的探讨原发性肝癌患者行超声引导下经皮微波消融(percutaneous microwave ablation,PMWA)联合肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)治疗的效果及安全性。方法101例原发性肝癌患者随机分为观察组52例和对照组49例。对照组给予TACE治疗,观察组给予TACE联合PMWA治疗。记录2组TACE治疗情况;分别于治疗前及末次TACE治疗后3周检测2组血清鳞状细胞癌抗原(squamous cell carcinoma antigen,SCC-Ag)、糖链抗原(carbohydrate antigen,CA)50、CA19-9、CA724水平;记录2组治疗期间并发症发生情况;末次TACE治疗后1个月评定2组治疗效果;随访观察2组远期生存情况。结果观察组TACE治疗次数[(2.56±0.31)次]较对照组[(3.98±0.42)次]少(P<0.05)。末次TACE治疗后1个月总有效率(84.62%)较对照组(67.35%)高(P<0.05)。观察组、对照组治疗后血清SCC-Ag[(3.65±0.47)、(5.52±0.71)μg/L]、CA50[(40.19±5.22)、(51.37±5.34)ku/L]、CA19-9[(50.30±6.31)、(61.20±7.75)ku/L]、CA724[(15.33±2.10)、(20.89±3.62)ku/L]水平均低于治疗前[SCC-Ag:(7.19±0.93)、(7.20±0.95)μg/L;CA50:(68.59±8.31)、(70.08±8.61)ku/L;CA19-9:(72.25±8.90)、(73.02±9.12)ku/L;CA724:(23.56±3.04)、(24.09±2.97)ku/L](P<0.05);观察组治疗后血清SCC-Ag、CA50、CA19-9、CA724水平低于对照组(P<0.05)。2组治疗期间均未发生气胸、肠瘘、肝包膜下出血、胆漏等严重并发症,观察组并发症发生率(17.31%)与对照组(14.29%)比较差异无统计学意义(P>0.05)。观察组24个月生存率(57.14%)高于对照组(36.17%)(P<0.05)。结论TACE联合PMWA治疗原发性肝癌可降低血清SCC-Ag、CA50、CA19-9、CA724水平,提高疗效,延长生存期,并发症发生率低。
Objective To investigate the efficacy of ultrasound-guided percutaneous microwave ablation combined with transcatheter arterial chemoembolization(TACE)on primary hepatocellular carcinoma and its safety.Methods A total of 101patients with primary hepatocellular carcinoma were randomly divided into 52patients treated with TACE and percutaneous microwave ablation(observation group)and 49patients treated with TACE(control group).The serum squamous cell carcinoma antigen(SCC-Ag),carbohydrate antigen(CA)50,CA19-9and CA724levels were measured before and 3weeks after the final TACE treatment.The complications and long-term survival were recorded.Results The frequency of TACE treatment was less in observation group(2.56±0.31)than that in control group(3.98±0.42)(P<0.05),and the total effective rate was higher in observation group(84.62%)than that in control group(67.35%)(P<0.05).The serum levels of SCC-Ag((3.65±0.47),(5.52±0.71)μg/L),CA50((40.19±5.22),(51.37±5.34)ku/L),CA19-9((50.30±6.31),(61.20±7.75)ku/L)and CA724((15.33±2.10),(20.89±3.62)ku/L)in observation and control groups were lower after treatment than those before treatment(SCC-Ag:(7.19±0.93),(7.20±0.95)μg/L;CA50:(68.59±8.31),(70.08±8.61)ku/L;CA19-9:(72.25±8.90),(73.02±9.12)ku/L;CA724:(23.56±3.04),(24.09±2.97)ku/L)(P<0.05),and lower in observation group than those in control group after treatment(P<0.05).No severe complications as pneumothorax,intestinal fistula,subcapsular hemorrhage of liver and biliary fistula occurred in two groups.The incidence of complications showed no significant difference between observation group(17.31%)and control group(14.29%)(P>0.05).The 24-month survival rate was higher in observation group(57.14%)than that in control group(36.17%)(P<0.05).Conclusion TACE combined with percutaneous microwave ablation can decrease the serum levels of SCC-Ag,CA50,CA19-9and CA724so as to improve the efficacy,reduce the complication and prolong the survival in patients with primary hepatocellular carcinoma.
作者
卞锦花
达婷
罗建梅
周琦
姜珏
吴涛
BIAN Jinhua;DA Ting;LUO Jianmei;ZHOU Qi;JIANG Jue;WU Tao(Department of Ultrasound,the First Affiliated Hospital of Xi'an Medical College,Xi'an 710007,China;Department of Ultrasound,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Department of Intervention,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)
出处
《中华实用诊断与治疗杂志》
2020年第5期509-512,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金青年科学基金(81501567)
陕西省科学技术厅社会发展科技攻关项目(2017SF-030)。
关键词
原发性肝癌
经皮微波消融术
肝动脉化疗栓塞
鳞状细胞癌抗原
糖链抗原50
糖链抗原19-9
糖链抗原724
primary hepatocellular carcinoma
percutaneous microwave ablation
transcatheter arterial chemoembolization
squamous cell carcinoma antigen
carbohydrate antigen 50
carbohydrate antigen 19-9
carbohydrate antigen 724