腹腔镜肝癌切除术后联合槐耳颗粒和仑伐替尼对预防肿瘤复发/转移的价值

Value of Combining Huaier Granules and Lenvatinib for Prevention of Tumor Recurrence/Metastasis after Laparoscopic Hepatectomy

目的探讨肝癌患者经腹腔镜肝切除术(laparoscopic hepatectomy,LH)后联合槐耳颗粒和仑伐替尼对预防肿瘤复发/转移的价值。方法回顾性分析2017年1月—2021年6月福建省莆田市第一医院肝胆胰脾外科行LH的患者94例的临床资料,按随机数表法分为观察组和对照组,各47例。对照组采用仑伐替尼进行靶向治疗,观察组在对照组基础上联合槐耳颗粒,对比两组近期复发与转移情况、炎症水平、肿瘤标志物和血清因子水平、免疫反应和不良反应。结果观察组的复发率为8.51%,较对照组的25.53%更低,差异有统计学意义(χ^(2)=4.821,P=0.028);观察组C反应蛋白(CRP)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、甲胎蛋白(AFP)、异常凝血酶原(DCP)、Toll样受体4(TLR4)、CD3^(+)、CD8^(+)水平较对照组更低,CD4^(+)、CD4^(+)/CD8^(+)水平更高,差异有统计学意义(P<0.05)。两组肝外转移率和不良反应发生率比较,差异无统计学意义(P>0.05)。结论经LH后采用槐耳颗粒联合仑伐替尼进行后续治疗,可有效降低术后1年内复发率,提高机体免疫应答,缓解机体炎症反应,发挥肿瘤抵抗作用,且具有较高安全性。

Objective To explore the value of combining Huaier granules and lenvatinib in preventing tumor recurrence/metastasis after laparoscopic hepatectomy(LH)in patients with hepatocellular carcinoma.Methods Retrospective analysis of the clinical data of 94 cases of LH patients in Hepatobiliary Pancreatic Splenic Surgery Department of the First Hospital of Putian City,Fujian Province from January 2017 to June 2021 They were randomly divided into the observation group and the control group,with 47 patients in each group.The control group received Targeted therapy with ranvartinib,and the observation group combined Huaier Granules on the basis of the control group to compare the recent recurrence and metastasis,inflammatory levels,tumor markers and serum factor levels,immune reactions and adverse reactions of the two groups.Results The recurrence rate in the observation group was 8.51%,which was lower than the 25.53%in the control group,and the difference was statistically significant(χ^(2)=4.821,P=0.028).C-reactive protein(CRP),interleukin-1(IL-1),Interleukin 6(IL-6),tumor necrosis factor-α(TNF-α),alpha fetoprotein(AFP),abnormal prothrombin(DCP),toll like receptor 4(TLR4),CD3^(+),and CD8^(+)in the observation group were lower than those in the control group,while the levels of CD4^(+),CD4^(+)/CD8^(+)were higher than in the control group,the difference was statistically significant(P<0.05).The rate of extrahepatic metastasis and the incidence of adverse reactions were compared between the two groups,the difference was not statistically significant(P>0.05).Conclusion Follow-up treatment with Huaier granules combined with lenvatinib after LH can effectively reduce the recurrence rate within 1 year after surgery,improve the body's immune response,alleviate the body's inflammatory response,and exert tumor resistance,and has a high safety profile.