肝癌切除术后行肝动脉化疗栓塞对肝癌患者血清肿瘤标志物的影响

Effect of transcatheter arterial chemoembolization after hepatectomy on serum tumor markers in liver cancer patients

目的探讨肝癌切除术后行肝动脉化疗栓塞(TACE)对肝癌患者血清肿瘤标志物的影响。方法选取2018年2月~2019年2月广东药科大学附属第一医院收治的78例原发性肝癌患者作为研究对象,采用抽签法分为研究组和对照组,每组各39例。对照组患者行常规肝癌切除术治疗,研究组则采用肝癌切除术后加用TACE治疗。在治疗前后,测定比较两组患者癌胚抗原(CEA)、甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)以及磷脂酰肌醇蛋白聚糖-3(GPC3)等血清肿瘤标志物的变化,并随访统计两组患者的1年复发率。结果两组患者治疗前的CEA、AFP、AFP-L3及GPC3四项血清肿瘤标志物水平比较,差异无统计学意义(P>0.05);两组患者治疗后的CEA、AFP、AFP-L3及GPC3水平均低于治疗前,差异有统计学意义(P<0.05);研究组治疗后的CEA、AFP、AFP-L3及GPC3水平均低于对照组,差异有统计学意义(P<0.05)。研究组的1年复发率低于对照组,差异有统计学意义(P<0.05)。结论肝癌患者在肝癌切除术后再行TACE,对于各种血清肿瘤标志物可以起到更显著的降低作用,且患者的复发率相对较低,临床应用的意义较大。

Objective To investigate the effect of transcatheter arterial chemoembolization(TACE)after hepatectomy on serum tumor markers in liver cancer patients.Methods A total of 78 patients with primary liver cancer admitted in The First Affiliated Hospital of Clinical Medicine of Guangdong Pharmaceutical University from February 2018 to February 2019 were selected as the research objects,and they were divided into the study group and the control group by the drawing lots method,with 39 cases in each group.The control group was performed with routine hepatectomy.The study group was treated with TACE after hepatectomy.The changes of serum tumor markers such as carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),alpha-fetoprotein heterojunction(AFP-L3)and glypican-3(GPC3)before and after treatment were measured and compared between the two groups.And the recurrence rate of the two groups was counted for one year.Results Comparison of four serum tumor markers including CEA,AFP,AFP-L3 and GPC3 between the two groups before treatment,The differences were not statistically significant(P>0.05).The CEA,AFP,AFP-L3 and GPC3 levels of the two groups were lower than those before treatment,the differences were statistically significant(P<0.05).The CEA,AFP,AFP-L3 and GPC3 levels of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).The 1 year recurrence rate in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion After hepatectomy,TACE for patients with primary liver cancer can play a more significant role in reducing serum tumor markers,and the recurrence rate of the patients is relatively low,so clinical application has important clinical significance.