肝动脉化疗栓塞联合阿帕替尼治疗原发性肝癌的安全性和有效性分析

Analysis of safety and efficacy of hepatic artery chemoembolization combined with apatinib in the treatment of hepatocellular carcinoma

目的研究肝动脉化疗栓塞(TACE)联合阿帕替尼治疗肝癌的安全性和有效性。方法选取我院于2017年1月至2020年5月期间收治的72例原发性肝癌患者为研究对象,按随机数字表法划分为观察组(n=36)与对照组(n=36)。对照组采用TACE治疗方案,观察组采用TACE联合阿帕替尼治疗方案,对两组患者治疗前与治疗后血清血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)浓度表达、肝功能指标、免疫功能指标、治疗效果、治疗期间不良反应发生率以及随访生存情况进行比较和评价。结果治疗前两组患者血清VEGF与MMP-9浓度、ALT、AST、TBil与PT水平、CD3^+、CD4^+/CD8^+与CD19^+比较均无显著差异(P>0.05);治疗后观察组血清VEGF与MMP-9浓度、ALT、AST水平、CD8^+均比对照组更低,CD3^+、CD4^+、CD4^+/CD8^+均比对照组更高(P<0.05)。术后两组患者随访半年内生存率对比差异不明显(P>0.05);观察组治疗总有效率、随访1年与2年内生存率、不良反应发生率均高于对照组(P<0.05)。结论对于肝癌患者,采用TACE联合阿帕替尼治疗方案与单独TACE相比,总体安全性好,并可显著改善生存期,提高细胞免疫功能与肝功能。

Objective To study the safety and efficacy of hepatic artery chemoembolization(TACE)combined with apatinib in the treatment of liver cancer.Methods A total of 72 patients with primary liver cancer admitted to our hospital from January 2017 to May 2020 were selected as study subjects and divided into observation group(n=36)and control group(n=36)according to the random number table method.The control group was treated with TACE,and the observation group was underwent TACE combined with apatinib(combined treatment).For the two groups of patients,serum vascular endothelial growth factor(VEGF)and matrix metalloproteinases 9(MMP 9)level,liver function,immune function before and after treatment and treatment effect,the incidence of adverse reactions during the treatment and follow-up survival situation were compared and evaluated.Results Before treatment,there were no significant differences in serum VEGF and MMP-9 levels,ALT,AST,TBil and PT levels,CD3^+,CD4^+/CD8^+and CD19^+between the two groups(P>0.05).After treatment,serum VEGF and MMP-9 concentrations,ALT,AST levels and CD8^+in the observation group were all lower than those in the control group,and CD3^+,CD4^+,and CD4^+/CD8^+were all higher than those in the control group(P<0.05).There was no significant difference between the two groups in the survival rate within six months after the operation(P>0.05).The total effective rate,1-year and 2-year survival rate and adverse reaction rate of the observation group were all higher than those of the control group(P<0.05).Conclusions For patients with liver cancer,compared with TACE alone,TACE combined with apatinib treatment has high safety and can significantly increase overall survival and improve cellular immune function and liver function.