超选择性肝动脉化疗栓塞术联合阿帕替尼对中晚期原发性肝癌患者血清MMP表达的影响

Effect of Superselective Hepatic Artery Chemoembolization Combined with Apatinib on Serum MMP Expression in Patients with Advanced Primary Liver Cancer

目的:探讨超选择性肝动脉化疗栓塞术(S-TACE)联合阿帕替尼在中晚期原发性肝癌(HCC)患者中的治疗效果。方法:回顾性分析2015年1月~2020年1月某院收治的87例中晚期HCC患者的病历资料,其中行S-TACE的43例中晚期HCC患者为对照组,行S-TACE联同阿帕替尼的44例HCC患者为观察组,连续用药28d,两组均随访1年。对比两组临床疗效、血清学指标、肝功能、生存率、不良反应。结果:观察组患者治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗前,两组基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)、谷丙转氨酶(ALT)、总胆红素(TBIL)、谷草转氨酶(AST)相比,差异无统计学意义(P>0.05);治疗后,观察组患者MMP-9、VEGF、ALT、TBIL、AST低于对照组,差异有统计学意义(P<0.05);观察组患者生存率高于对照组,差异有统计学意义(P<0.05);两组不良反应比较,差异无统计学意义(P>0.05)。结论:S-TACE联合阿帕替尼能够改善中晚期HCC患者血清学指标及肝功能,提高生存率,且无严重不良反应,安全可行。

Objective:To investigate the therapeutic effect of superselective hepatic arterial chemoembolization(S-TACE)combined with apatinib in the treatment of patients with advanced primary liver cancer(HCC).Methods:The medical records of 87 patients with advanced HCC admitted to a hospital from January 2015 to January 2020 were retrospectively analyzed.Among them,43 patients with advanced HCC who underwent S-TACE were selected as the control group.The 44 HCC patients treated with S-TACE combined with apatinib were selected as the observation group.They were treated continuously for 28 days,and followed up for 1 year.The clinical efficacy,serological indicators,liver function,survival rate,and adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was higher than that in the control group,with statistical difference(P<0.05).Before treatment,there was no statistical difference in matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF),alanine aminotransferase(ALT),total bilirubin(TBIL),and aspartate aminotransferase(AST)between the two groups(P>0.05).After treatment,the MMP-9,VEGF,ALT,TBIL,and AST in the observation group were lower than those in the control group,and there was statistical difference between the two groups(P<0.05).The survival rate of the observation group was higher than that of the control group,and there was statistical difference(P<0.05).The adverse reactions of the two groups were similar,and there was no statistical difference(P>0.05).Conclusion:S-TACE combined with apatinib can improve the serum indexes and liver function of patients with advanced HCC,and improve the survival rate,which is safe and feasible,with no serious adverse reactions.