腹腔镜肝癌射频消融联合肝动脉化疗栓塞对中晚期原发性肝癌疗效及肿瘤标志物指标的影响

Effect of laparoscopic radiofrequency ablation of hepatocellular carcinoma combined with TACE on efficacyand tumor activity index of middle and advanced primary hepatocellular carcinoma

目的分析中晚期原发性肝癌应用腹腔镜肝癌射频消融联合肝动脉化疗栓塞(transarterial chemoemboliza⁃tion,TACE)治疗的疗效及对肝功能和肿瘤标志物指标的影响。方法选取2017年4月至2019年12月郑州大学第一附属医院收治的中晚期原发性肝癌患者78例,根据治疗方法不同分组,将应用TACE治疗的39例定为对照组,应用腹腔镜肝癌射频消融联合TACE治疗的39例定为观察组,分析对比不同治疗方法的治疗效果。结果观察组治疗后临床有效率(89.74%)高于对照组(69.23%)(P<0.05);肝功能方面对比显示两组患者治疗前差异无统计学意义(P>0.05),治疗后3天观察组ALT、AST、TBiL指标[(91.35±12.16)U/L、(85.42±12.36)U/L及(32.42±5.37)μmol/L]显著高于对照组,治疗后3个月观察组患者ALT、AST、TBiL指标[(49.77±8.20)U/L、(20.86±4.70)U/L及(20.85±4.70)μmol/L]显著低于对照组(P<0.05);两组患者治疗前肿瘤标志物因子差异无统计学意义(P>0.05),观察组治疗后AFP、VEGF、MMP-9指标分别为(75.60±8.78)ng/mL、(221.46±31.25)ng/mL及(186.70±32.52)ng/mL,均低于对照组治疗后(P<0.05);观察组患者治疗后PFS高于对照组,1年和3年生存率分别为87.17%和53.84%,均高于对照组(66.66%和28.20%)(P<0.05);观察组发热、肝内感染、胃肠道反应等并发症发生率(84.61%)明显高于对照组(46.15%)(P<0.05)。结论针对中晚期原发性肝癌患者应用腹腔镜肝癌射频消融联合TACE的实际治疗效果良好,值得临床推广应用。

Objective To analyze the effect of laparoscopic radiofrequency ablation of liver cancer combined with TACE on liver function and tumor markers in advanced primary liver cancer.Methods A total of 78 patients with intermediate and advanced primary liver cancer admitted to our hospital from April 2017 to December 2019 were selected for observa⁃tion.According to the differences in treatment methods,39 patients treated with TACE were selected as the control group,and 39 patients treated with laparoscopic radiofofency ablation of liver cancer combined with TACE were selected as the observation group.The therapeutic effects of different therapeutic methods were analyzed and compared.Results The clinical effective rate of the observation group(89.74%)was higher than that of the control group(69.23%)(P<0.05).The comparison of liver function showed that there was no significant difference between the two groups before treatment(P>0.05).At 3 days after treatment,the indices of ALT,AST and TBiL in the observa⁃tion group[(91.35±12.16)U/L,(85.42±12.36)U/L and(32.42±5.37)μmol/L]were significantly higher than those in the control group.Three months after treatment,the indices of ALT,AST and TBiL in observation group[(49.77±8.20)U/L,(20.86±4.70)U/L and(20.85±4.70)μmol/L]were significantly lower than those in control group(P<0.05).There was no significant difference in tumor marker factors between the two groups before treatment(P>0.05).After treatment,the indexes of AFP,VEGF and MMP-9 in the observation group were(75.60±8.78)ng/mL,(221.46±31.25)ng/mL and(186.70±32.52)ng/mL,respectively.All of them were lower than those in control group(P<0.05).After treatment,the PFS of observation group was higher than that of control group,and the 1-year and 3-year survival rates were 87.17%and 53.84%,respectively,which were higher than those of control group(66.66%and 28.20%)(P<0.05).The incidence of complications such as fever,intrahepatic infection and gastrointestinal reaction in the observation group(84.61%)was significantly higher than that in the control group(46.15%)(P<0.05).Conclusion Laparoscopic radiofrequency ablation of liver cancer combined with TACE has good therapeutic effect for patients with advanced primary liver cancer,and is worthy of clinical application.