阿帕替尼对中晚期肝癌患者TACE术后血管生成因子水平的影响

Effect of apatinib on angiogenic factors of patients with advanced unresectable hepatocellular carcinoma after transarterial chemoembolization

目的观察阿帕替尼对中晚期肝癌患者肝动脉化疗栓塞术(TACE)后血管生成因子水平的影响。方法选择2018年3月至2020年3月山西省运城市中心医院收治的78例中晚期肝癌患者作为研究对象,随机分为联合组(39例)和TACE组(39例)。TACE组以TACE术进行治疗,联合组在TACE组基础上使用阿帕替尼治疗。比较两组治疗前后各时点血管内皮生长因子(VEGF)、甲胎蛋白(AFP)和含半胱氨酸的天冬氨酸蛋白水解酶-8(Caspace-8)水平。结果联合组治疗总有效率为66.67%(26/39),高于TACE组的43.5%(17/39),差异有统计学意义(χ^(2)=4.198,P=0.040)。两组治疗前VEGF水平分别为(229.36±23.85)pg/mL和(228.61±24.16)pg/mL,差异无统计学意义(t=0.138,P=0.891);治疗后8周VEGF水平分别为(135.16±12.82)pg/mL和(162.17±15.25)pg/mL,差异有统计学意义(t=8.467,P<0.01)。两组治疗前AFP水平分别为(462.79±22.16)ng/mL和(468.25±22.81)ng/mL,差异无统计学意义(t=1.072,P=0.287);治疗后8周AFP水平分别为(84.16±12.47)ng/mL和(139.62±13.85)ng/mL,差异有统计学意义(t=18.584,P<0.01)。两组治疗前Caspace-8水平分别为(81.37±11.28)pg/mL和(82.15±11.67)pg/mL,差异无统计学意义(t=0.300,P=0.765);治疗后8周Caspace-8水平分别为(104.92±13.46)pg/mL和(95.74±12.84)pg/mL,差异有统计学意义(t=3.082,P=0.003)。结论阿帕替尼用于不可切除中晚期肝癌患者TACE术后疗效较好,可降低VEGF、AFP、Caspace-8水平,具有推广价值。

Objective To observe the effect of apatinib on the levels of angiogenic factors in patients with advanced unresectable liver cancer after transcarterial chemoembolization(TACE).Methods Seventy-eight patients with advanced liver cancer in our hospital from March 2018 to March 2020 were selected as the research objects and randomly divided into combination group(39 cases)and TACE group(39 cases).The TACE group was treated with TACE,and the combination group was treated with apatinib and TACE.The clinical effects of the 2 groups were compared,and the levels of vascular endothelial growth factor(VEGF),alpha fetoprotein(AFP)and caspase-8 were compared before and after treatment.Results After treatment,compared with TACE group(43.59%),the total effective rate of combination group(66.67%)was significantly higher(P<0.05).The levels of VEGF before treatment were(229.36±23.85)pg/mL and(228.61±24.16)pg/mL in 2 groups,respectively,with no significant difference(P>0.05).Eight weeks after treatment,the VEGF levels were(135.16±12.82)pg/mL and(162.17±15.25)pg/mL,respectively,which were significantly lower than those before treatment,and the level in combination group was lower(P<0.05).The levels of AFP before treatment were(462.79±22.16)ng/mL and(468.25±22.81)ng/mL in 2 groups,respectively,with no significant difference(P>0.05).Eight weeks after treatment,the levels of AFP were(84.16±12.47)ng/mL and(139.62±13.85)ng/mL,respectively,which were significantly lower than those before treatment,and the level in combined group were lower(P<0.05).The levels of caspase-8 before treatment were(81.37±11.28)pg/mL and(82.15±11.67)pg/mL in 2 groups,respectively,with no significant difference(P>0.05).Eight weeks after treatment,caspase-8 levels were(104.92±13.46)pg/mL and(95.74±12.84)pg/mL,respectively,which were significantly higher than those before treatment,and the level in combination group was higher(P<0.05).Conclusion Apatinib has a good effect on patients with unresectable advanced liver cancer after TACE.It can improve the levels of VEGF,AFP,and caspace-8,which is worthy promoting.