BCLC中间期肝细胞癌患者术后经动脉化疗栓塞的临床价值

Clinical value of transcatheter arterial chemoembolization in patients with intermediate hepatocellular carcinoma after BCLC

目的探讨巴塞罗那临床肝癌分期(BCLC)中间期肝细胞癌患者术后经动脉化疗栓塞的临床价值。方法随机选取外科和介入科2016年1月至2020年1月收治的BCLC中间期肝细胞癌患者56例,其中单纯行肝癌切除术患者25例(对照组),肝癌切除术后行TACE患者31例(TACE组)。观察患者治疗后的疗效,检测患者治疗前后血清肝功能指标(丙氨酸氨基转移酶、门冬氨酸氨基转移酶、总胆红素、直接胆红素、白蛋白)和肿瘤标志物(甲胎蛋白、糖类抗原199)水平,随访并统计其生存时间。结果TACE组患者的总有效率为96.77%显著高于对照组的80.00%(P<0.05)。TACE组患者的血清肝功能各项指标和肿瘤标志物均显著性低于对照组,且相比治疗前,2组患者治疗后的血清肝功能和肿瘤标志物均显著性降低(P<0.05)。与对照组患者相比,TACE组患者的无瘤生存时间和总生存时间均显著性升高(P<0.05)。结论BLCL中间期肝细胞癌患者术后经动脉化疗栓塞具有临床价值,肝癌切除术联合经动脉化疗栓塞可有效治疗BLCL中间期肝细胞癌患者,改善其肝功能状态,延长其生存时间,值得临床应用与推广。

Objective To investigate the clinical value of transcatheter arterial chemoembolization(TACE)in patients with intermediate hepatocellular carcinoma(HCC)according to Barcelona clinical stage of liver cancer(BCLC).Methods A total of 56 patients with BCLC intermediate stage hepatocellular carcinoma who were treated in our hospital from January 2016 to January 2020 were enrolled in the study,of whom,25 patients were treated by simple hepatectomy(control group),and the other 31 patients were treated by TACE(TACE group).The curative effects,and the serum levels of liver function indexes including alanine aminotransferase,alanine aminotransferase,total bilirubin,direct bilirubin,albumin,and tumor markers(alpha fetoprotein,carbohydrate antigen 199)observed and compared between the two groups,Moreover the patients in both groups were followed up to observe their survival time.Results The total effective rate in TACE group was 96.77%,which was significantly higher than that(80.00%)in control group(P<0.05).After treatment the serum liver function indexes and tumor markers in both groups were significantly decreased,moreover,which in TACE group were significantly lower than those in control group(P<0.05).Moreover the tumor free survival time and overall survival time in TACE group were significantly higher than those in control group(P<0.05).Conclusion The therapeutic effects of TACE on intermediate HCC are significant,and hepatectomy combined with TACE can improve the liver function and prolong the survival time of patients with BLCL intermediate HCC,thus,it is worthy of clinical application and promotion.