超声引导下射频消融治疗肝癌的疗效及血清CTC、HGF水平变化研究

Clinical effects of ultrasound-guided radiofrequency ablation in the treatment of liver cancer and changes in serum CTC and HGF levels

目的探讨超声引导下射频消融治疗肝癌的疗效及患者血清循环肿瘤细胞(CTC)、肝细胞生长因子(HGF)水平的变化。方法选取2017年1月至2019年10月陕西省咸阳市核工业二一五医院收治的82例经病理组织检查证实为肝癌的患者作为研究对象,按照随机数表法分为对照组(n=40)和观察组(n=42),对照组行经肝动脉栓塞化疗术治疗,观察组行超声引导下射频消融治疗,比较两组患者的临床疗效、血清CTC、HGF水平、肝功能、并发症发生率及复发率。结果观察组患者的治疗总有效率为85.71%,明显高于对照组的65.00%,差异有统计学意义(P<0.05);治疗后,观察组患者的CTC、HGF水平分别为(3.51±0.87)/5 mL和(0.39±0.09)ng/L,明显低于对照组的(5.24±0.63)/5 mL和(0.48±0.10)ng/L,差异均有统计学意义(P<0.05);治疗后,观察组患者的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血清总胆红素(TBIL)水平分别为(27.12±5.33)U/mL、(32.78±7.35)U/mL、(30.58±5.26)μmol/L,明显低于对照组的(37.39±6.28)U/mL、(41.36±6.94)U/mL、(36.34±5.93)μmol/L,差异均有统计学意义(P<0.05);观察组患者的并发症发生率为4.76%,明显低于对照组的20.00%,差异有统计学意义(P<0.05);观察组患者随访1年内复发率为7.14%,对照组1年内复发率为15.00%,两组患者1年内复发率比较差异无统计学意义(P>0.05)。结论超声引导下射频消融治疗肝癌疗效确切,其可显著降低患者的血清CTC、HGF水平,有助于肝功能的康复,患者的并发症发生率较低。

Objective To investigate the efficacy of ultrasound-guided radiofrequency ablation in the treatment of liver cancer and changes in serum levels of circulating tumor cells(CTC)and hepatocyte growth factor(HGF).Methods Totally 82 patients with histopathologically confirmed liver cancer who were admitted to Xianyang 215 Hospital of Nuclear Industry between January 2017 and October 2019 were enrolled and divided into control group(n=40)and observation group(n=42)by random number table method.The control group received transhepatic arterial chemoembolization,while the observation group received ultrasound-guided radiofrequency ablation.Clinical effects,serum CTC,and HGF levels,liver function,the incidence of complications,and recurrence rates were compared between the two groups.Results The total effective rate of treatment in the observation group was 85.71%,significantly higher than 65.00% in the control group(P<0.05).After treatment,the levels of CTC,HGF,alanine aminotransferase(ALT),aspartate aminotransferase(AST),and serum total bilirubin(TBIL)in the observation group were(3.51±0.87)/5 mL,(0.39±0.09)ng/L,(27.12±5.33)U/mL,(32.78±7.35)U/mL,and(30.58±5.26)μmol/L,significantly lower than(5.24±0.63)/5 mL,(0.48±0.10)ng/L,(37.39±6.28)U/mL,(41.36±6.94)U/mL,and(36.34±5.93)μmol/L in the control group(P<0.05).The incidence of complications in the observation group was 4.76%,significantly lower than 20.00% in the control group(P<0.05),but no significant difference was found in the 1-year recurrence rate between the two groups(7.14%vs 15.00%,P>0.05).Conclusion Ultrasound-guided radiofrequency ablation is effective in the treatment of liver cancer.It can significantly lower serum levels of CTC and HGF,and promote the recovery of liver function,with a low incidence of complications rate.