TACE联合RFA治疗中期原发性肝癌的疗效及对患者血清GP73、AFP和AFP-L3水平的影响

Efficacy of TACE combined with RFA in the treatment of mid-term primary liver cancer and its influence on serum levels of GP73,AFP and AFP-L3

目的探讨肝动脉化疗栓塞术(TACE)联合射频消融术(RFA)治疗中期原发性肝癌患者的近期疗效,及对患者血清高尔基体蛋白73(GP73)、甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)水平的影响,并分析患者临床基线特征对疗效的影响。方法回顾性选取2018年3月至2019年10月邢台市人民医院收治的86例中期原发性肝癌患者资料,所有患者均采用TACE联合RFA治疗。比较患者治疗前后血清GP73、AFP、AFP-L3水平变化,并在术后1、6、12个月评估临床疗效并分析影响疗效的基线资料特征,随访12个月记录患者的生存率及不良反应情况。结果治疗后,患者血清GP73、AFP、AFP-L3水平为(93.15±7.83)ng/mL、(68.62±13.18)ng/mL、(5.32±1.08)%,均较治疗前[(184.51±16.25)ng/mL、(5148.62±263.83)ng/mL、(16.42±5.03)%]明显降低,差异均有统计学意义(P<0.05)。治疗后,对患者进行随访1年,术后1、6、12个月客观缓解率分别为50.00%、54.65%、45.35%。经单因素分析患者临床基线数据中Child-pugh分级、肿瘤数目、肿瘤最大直径是影响术后疗效的重要因素;术后出现6例患者出现右侧少-中量胸腔积液,73例患者出现发热、呕吐等不良反应,对症治疗后症状均明显缓解。结论TACE联合RFA是治疗中期原发性肝癌的有效方法,可有效降低患者血清GP73、AFP、AFP-L3水平,Child-pugh分级、肿瘤数目、肿瘤最大直径是影响中期原发性肝癌患者术后疗效的重要因素。

Objective To investigate the short-term efficacy of transcatheter arterial chemoembolization(TACE)combined with radiofrequency ablation(RFA)in the treatment of mid-term primary liver cancer,and its influence on the serum levels of Golgi protein 73(GP73),alpha fetoprotein(AFP)and alpha fetoprotein heterogeneity(AFP-L3),and to analyze the influence of clinical baseline characteristics on the efficacy.Methods The data of 86 patients with mid-term primary liver cancer admitted to Xingtai People's Hospital from March 2018 to October 2019 were selected retrospectively.All patients were treated with TACE combined with RFA.The changes of serum GP73,AFP and AFP-L3 levels before and after treatment were compared.The clinical efficacy was evaluated at 1,6 and 12 months after operation,and the baseline data characteristics affecting the efficacy were analyzed.The survival rate and adverse reactions were recorded after 12 months of follow-up According to the situation.Results After treatment,the serum GP73 level was(93.15±7.83)ng/mL,AFP level was(68.62±13.18)ng/mL,AFP-L3 level was(5.32±1.08)%,which were significantly lower than before treatment[(184.51±16.25)ng/mL,(5148.62±263.83)ng/mL,(16.42±5.03)%],the differences were statistically significant(P<0.05);after treatment,the patients were followed up for 1 year,the objective remission rates were 50.00%,54.65%,and 45.35%at 1,6,and 12 months after the operation.By univariate analysis,the clinical baseline data of the patients with child pugh the grade,the number of tumor and the largest diameter of tumor were the important factors affecting the postoperative curative effect;6 patients had right small to moderate pleural effusion,73 patients had fever,vomiting and other adverse reactions,and the symptoms were significantly relieved after symptomatic treatment.Conclusion TACE combined with RFA is an effective method for the treatment of mid-term primary liver cancer,which can effectively reduce the serum levels of GP73,AFP and AFP-L3.Child Pugh grade,tumor number and maximum tumor diameter are important factors affecting the postoperative efficacy of patients with mid-term primary liver cancer.