载药微球经导管肝动脉化疗栓塞术治疗原发性肝癌患者的疗效及对血清胎盘生长因子、异常凝血酶原水平的影响

Transcatheter arterial chemoembolization with drug-loaded microspheres in primary liver cancer and effect on placental growth factor and prothrombin induced by vitamin K absence-Ⅱ

目的探讨载药微球经导管肝动脉化疗栓塞术(TACE)治疗原发性肝癌(PLC)的疗效及其对患者血清胎盘生长因子(PLGF)、异常凝血酶原(PIVKA-Ⅱ)水平的影响。方法采用随机数字表法将70例PLC患者分为对照组和观察组,每组35例。对照组给予125I放射性粒子联合常规TACE治疗,观察组给予125I放射性粒子联合载药微球TACE治疗。比较两组患者的近期疗效、生存情况、不良反应发生情况及血清PLGF、PIVKA-Ⅱ水平。结果治疗2个月后,观察组患者的客观缓解率(ORR)、疾病控制率(DCR)均高于对照组(P<0.05)。对照组患者的平均肿瘤缩小率、肿瘤坏死面积率均明显低于观察组(P<0.01)。两组患者的中位无进展生存时间比较,差异有统计学意义(P<0.05)。对照组患者的不良反应总发生率明显高于观察组(P<0.01)。治疗2个月后,两组患者的血清PLGF、PIVKA-Ⅱ水平均低于本组治疗前,且观察组患者的血清PLGF、PIVKA-Ⅱ水平均低于对照组(P<0.05)。结论载药微球TACE治疗PLC可有效提高患者的临床疗效,延长患者的生存期,且降低患者的血清PLGF、PIVKA-Ⅱ水平。

Objective To investigate the efficacy of transcatheter arterial chemoembolization with drug-loaded microspheresin primary liver cancer(PLC) and its effect on serum placental growth factor(PLGF) and prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ) levels.Method 70 patients with PLC were randomly divided into control group and observation group,with 35 cases in each.Patients were treated with 125I radioactive particles combined transcatheter arterial chemoembolization(TACE) in the control group,and 125I radioactive particles combined transcatheter arterial chemoembolization with drug-loaded microspheres in the observation group.The short-term efficacy,survival,adverse reactions,and serum PLGF and PIVKA-Ⅱ levels before and after treatment were compared.Result The objective response rate(ORR) and disease control rate(DCR) in the observation group were significantly higher than the control group(P<0.05);with significantly higher average tumor shrinkage rate and tumor necrosis area rate than the control gourp(P<0.01) and significant difference in median progression-free survival time(P<0.05) after 2 months of treatment.There were no serious complications in both groups,with significant higher adverse effects in the control group than the observation group(P<0.01).After 2 months of treatment,the serum PLGF and PIVKA-Ⅱ levels of the two groups were significantly lower than those before treatment,and significantly lower in the observation than those in the control group(P<0.05).Conclusion Transcatheter arterial chemoembolization with drug-loaded microspheres can effectively improve the efficacy of PLC patients,prolong the survival of patients,and significantly reduce the serum PLGF and PIVKA-Ⅱ levels.