CalliSpheres载药微球栓塞介入与甲磺酸阿帕替尼联合治疗晚期肝癌的疗效及预后观察

Efficacy and prognosis of CalliSpheres drug loaded microspheres embolization intervention combined with Apatinib mesylate in the treatment of advanced liver cancer

目的探讨CalliSpheres载药微球栓塞介入与甲磺酸阿帕替尼联合治疗晚期肝癌疗效及预后生存状况的影响。方法选取2017年2月至2019年12月我院晚期肝癌患者82例,以随机单盲法分为观察组(n=41)、对照组(n=41)。对照组予以CalliSpheres载药微球栓塞介入治疗,观察组在对照组基础上联合甲磺酸阿帕替尼治疗,均治疗3个月。比较两组临床疗效、治疗前、治疗2个月、3个月后肿瘤恶性生物学行为指标[亮氨酸拉链EF-hand结构域跨膜蛋白1(LETM1)、磷脂酰肌醇3激酶(PI3K)、细胞周期蛋白D1(CyclinD1)、波形蛋白(Vimentin)、N-钙黏蛋白(N-cadherin)]、血管生成有关指标[碱性成纤维细胞生长因子(bFGF)、血管内皮细胞生长因子(VEGF)、微血管密度(MVD)]、肿瘤标志物[甲胎蛋白(AFP)、高尔基蛋白73(GP73)、甲胎蛋白异质体3(AFP-L3)]水平,并统计不良反应发生率与治疗后6个月、9个月、12个月生存率。结果观察组治疗3个月后总有效率(65.85%)较对照组(41.46%)高(P<0.05);观察组治疗2个月、3个月后肝癌组织中LETM1、PI3K、CyclinD1、Vimentin、N-cadherin水平均低于对照组(P<0.05);观察组治疗2个月、3个月后血清bFGF、VEGF、AFP、GP73、AFP-L3与MVD水平均低于对照组(P<0.05);观察组血压升高、心脏毒性、上消化道出血、手足综合征发生率(21.95%、24.39%、19.51%、14.63%)较对照组高(4.88%、7.32%、2.44%、0)(P<0.05);观察组治疗后9个月、12个月生存率(64.10%、51.28%)较对照组(41.03%、28.21%)高(P<0.05)。结论CalliSpheres载药微球栓塞介入与甲磺酸阿帕替尼联合用于晚期肝癌患者,可降低血清bFGF、VEGF、AFP、GP73、AFP-L3与MVD水平,抑制血管生成及癌细胞侵袭、增殖,降低肿瘤恶性生物学行为,提高治疗效果及生存率,但不良反应较多。

Objective To investigate the effect of CalliSpheres drug loaded microspheres embolization intervention combined with Apatinib mesylate in the treatment of advanced liver cancer and its prognosis.Methods A total of 82 patients with advanced liver cancer in our hospital from Feb.2017 to Dec.2019 were selected and divided into observation group(n=41)and control group(n=41)by random single-blind method.The control group was treated with CalliSpheres drug loaded microsphere embolization intervention,and the observation group was treated with Apatinib mesylate on the basis of the control group,and both were treated for 3 months.The clinical efficacy and the biological behavior indicators of tumor malignancy[leucine zipper EF-hand domain transmembrane protein 1(LETM1),phosphatidylinositol 3-kinase(PI3K),cyclin D1(CyclinD1),Vimentin,N-cadherin],angiogenesis-related indicators[basic fibroblast growth factor(bFGF),vascular endothelial cell growth factor(VEGF),microvessel density(MVD)],tumor markers[alpha-fetoprotein(AFP),Golgi protein 73(GP73),alpha-fetoprotein heterogene 3(AFP-L3)]levels before treatment,2 months and 3 months after treatment were compared between the two groups.The adverse reaction rates and survival rates at 6 months,9 months and 12 months after treatment were also counted.Results The total effective rate(65.85%)in the observation group after 3 months of treatment was higher than that in the control group(41.46%)(P<0.05).The levels of LETM1,PI3K,CyclinD1,Vimentin and N-cadherin in liver cancer tissues in the observation group were lower than those in the control group after 2 months and 3 months of treatment(P<0.05).The serum levels of bFGF,VEGF,AFP,GP73,AFP-L3 and MVD in the observation group were lower than those in the control group after 2 months and 3 months of treatment(P<0.05).The incidences of elevated blood pressure,cardiotoxicity,upper gastrointestinal bleeding,and hand-foot syndrome(21.95%,24.39%,19.51%,14.63%)in the observation group were higher than those in the control group(4.88%,7.32%,2.44%,0)(P<0.05).The 9-month and 12-month survival rates(64.10%,51.28%)of the observation group were higher than those of the control group(41.03%,28.21%)(P<0.05).Conclusion CalliSpheres drug-loaded microsphere embolization intervention combined with Apatinib mesylate in patients with advanced liver cancer can reduce serum bFGF,VEGF,AFP,GP73,AFP-L3 and MVD levels.It can inhibit angiogenesis and cancer cell invasion and proliferation,reduce the malignant biological behavior of tumors,and improve the therapeutic effect and survival rate,but there are many adverse reactions.