对不可进行病灶切除术的结直肠癌肝转移患者实施肝动脉持续灌注化疗的效果

Effects of continuous hepatic arterial perfusion chemotherapy in patients with liver metastasis from colorectal cancer who cannot undergo resection

目的:探讨对不可进行病灶切除术的结直肠癌肝转移患者实施肝动脉持续灌注化疗的效果。方法:选取近几年东莞市东华医院收治的40例结直肠癌肝转移患者作为研究对象。这些患者均不适合使用病灶切除术进行治疗。随机将这些患者分为对照组和研究组。对对照组患者进行全身化疗,对研究组患者进行肝动脉持续灌注化疗。然后观察两组患者血清癌胚抗原(CEA)、糖类抗原199(CA199)、免疫功能指标、血管内皮生长因子(VEGF)、基质金属蛋白酶9(MMP9)的水平及发生不良反应的情况。结果:治疗后,研究组患者血清CEA、CA199、VEGF及MMP9的水平均低于对照组患者,其血清CD4^(+)、CD8^(+)的水平及CD4^(+)/CD8^(+)均高于对照组患者,P<0.05。治疗后,两组患者贫血、恶心呕吐、肝脏毒性反应及血小板减少的发生率相比,P>0.05。结论:对不可进行病灶切除术的结直肠癌肝转移患者实施肝动脉持续灌注化疗可降低其血清肿瘤标志物、VEGF及MMP9的水平,提高其免疫力,且安全性较高。

Objective:To investigate the effect of continuous hepatic artery perfusion chemotherapy in patients with liver metastasis of colorectal cancer who cannot be excised.Methods:Forty patients with liver metastasis of colorectal cancer admitted to Donghua Hospital of Dongguan city in recent years were selected as the research object.None of these patients is suitable for treatment with focal resection.These patients were randomly divided into control group and study group.Patients in the control group received systemic chemotherapy,and patients in the study group received continuous hepatic artery perfusion chemotherapy.Then,the levels of serum carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),immune function indexes,vascular endothelial growth factor(VEGF),matrix metalloproteinase 9(MMP9)and the occurrence of adverse reactions in 2 groups were observed.Results:After treatment,the levels of CEA,CA199,VEGF and MMP9 in the study group were lower than those in the control group,and the levels of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)were higher than those in the control group,P<0.05.After treatment,the incidence of anemia,nausea and vomiting,liver toxicity and thrombocytopenia in 2 groups were compared,P>0.05.Conclusions:Continuous hepatic arterial perfusion chemotherapy can reduce the levels of tumor markers,VEGF and MMP9 in serum and improve the immunity of patients with liver metastasis of colorectal cancer who cannot be excised with lesion resection,with high safety.