肝癌切除术联合肝动脉化疗栓塞术治疗中晚期肝癌疗效观察

Effect of hepatectomy combined with transcatheter hepatic arterial chemoembolization in the treatment of middle-advanced liver cancer

目的探讨肝癌切除术联合肝动脉化疗栓塞术(TACE)治疗中晚期肝癌的临床疗效。方法选择2015年1月至2018年1月长安医院收治的126例中晚期肝癌患者为研究对象,根据治疗方式将患者分为观察组(n=70)和对照组(n=56),对照组患者行肝癌切除术,观察组患者行肝癌切除术联合TACE。对2组患者治疗前及治疗后1个月血清甲胎蛋白(AFP)、血管内皮生长因子(VEGF)水平进行比较;治疗后2个月采用世界卫生组织实体瘤客观疗效评价标准评估2组患者的近期临床疗效;采用Kaplan-Meier法分析中晚期肝癌患者生存情况。结果治疗前2组患者血清AFP、VEGF水平比较差异无统计学意义(P>0.05),2组患者治疗后1个月血清AFP、VEGF水平显著低于治疗前(P<0.05);治疗后1个月,观察组患者血清AFP、VEGF水平显著低于对照组(P<0.05)。观察组患者完全缓解率和总有效率分别为34.29%(24/70)、85.71%(60/70),对照组患者完全缓解率和总有效率分别为17.86%(10/56)、69.64%(39/56),观察组患者完全缓解率和总有效率均显著高于对照组(χ^(2)=4.262、4.773,P<0.05)。Kaplan-Meier生存分析显示,观察组和对照组患者术后2 a总生存率分别为48.57%(34/70)、35.71%(20/56),观察组患者术后2 a总生存率显著高于对照组(χ^(2)=4.005,P<0.05)。结论肝癌切除术联合TACE可以提高中晚期肝癌患者的近期治疗效果和生存率。

Objective To investigate the clinical efficacy of hepatectomy combined with transcatheter hepatic arterial chemoembolization(TACE)in the treatment of middle-advanced liver cancer.Methods A total of 126 patients with middle-advanced liver cancer admitted to Chang′an Hospital from January 2015 to January 2018 were selected as the research subjects,and the patients were divided into observation group(n=70)and control group(n=56)according to the treatment method.The patients in the control group underwent hepatectomy,while the patients in the observation group underwent hepatectomy combined with TACE.The levels of serum alpha fetoprotein(AFP)and vascular endothelial growth factor(VEGF)were compared between the two groups before and one month after treatment.Two months after treatment,the short-term clinical efficacy of the patients in the two groups was evaluated by the Response Evaluation Criteria in Solid Tumors of World Health Organization.The survival of patients with middle-advanced liver cancer was analyzed by Kaplan-Meier method.Results There was no significant difference in the levels of serum AFP and VEGF between the two groups before treatment(P>0.05).The levels of serum AFP and VEGF at one month after treatment were significantly lower than those before treatment in the two groups(P<0.05).The levels of serum AFP and VEGF in the observation group were significantly lower than those in the control group at one month after treatment(P<0.05).The complete remission rate and total effective rate in the observation group were 34.29%(24/70)and 85.71%(60/70),respectively;and the complete remission rate and total effective rate in the control group were 17.86%(10/56)and 69.64%(39/56),respectively.The complete remission rate and total effective rate in the observation group were significantly higher than those in the control group(χ^(2)=4.262,4.773;P<0.05).Kaplan Meier survival analysis showed that the two-year overall survival rate of patients in the observation group and the control group was 48.57%(34/70)and 35.71%(20/56),respectively.The two-year overall survival rate of patients in the observation group was significantly higher than that in the control group(χ^(2)=4.005,P<0.05).Conclusion The hepatectomy combined with TACE can improve the short-term treatment effect and survival rate of patients with middle-advanced liver cancer.