载药微球化疗栓塞术治疗中晚期肝癌患者疗效及对血清GGT、钙磷代谢的影响

Effect of chemoembolization with drug-loaded microspheres on therapeutic effect and serum GGT,calcium and phosphorus metabolism in patients with advanced liver cancer

目的探讨中晚期肝癌患者采取载药微球化疗栓塞术的疗效。方法选取2018年5月至2023年1月阜阳市人民医院收治的65例中晚期肝癌患者,按不同手术方法分为2组,对照组(肝动脉化疗栓塞术)31例,观察组(载药微球化疗栓塞术)34例,比较两组疗效。结果观察组GGT(28.26±2.62)U/L低于对照组(53.99±3.71)U/L;CA19-9(6.84±0.26)U/mL低于对照组(12.58±0.48)U/mL;AFP(310.87±5.52)ng/mL低于对照组(459.26±6.18)ng/mL(t=32.522、60.674、102.256,P<0.05)。术后1个月,观察组血Ga(2.12±0.14)mmol/L、iPTH(179.56±19.52)pg/mL、钙磷乘积(45.86±3.62)mg^(2)/dL均低于对照组的(2.20±0.15)mmol/L、(206.84±22.17)pg/mL、(51.47±4.26)mg^(2)/dL,血P(1.56±0.13)mmol/L高于对照组(1.83±0.14)mmol/L,钙磷乘积(45.86±3.62)mg^(2)/dL低于对照组(51.47±4.26)mg^(2)/dL(t=2.224、5.275、5.737、8.062,均P<0.05)。术后1个月,观察组ALT(44.26±3.52)U/L低于对照组(53.97±4.17)U/L,AST(36.85±5.14)U/L低于对照组(48.10±6.71)U/L,TBil(16.56±2.62)μmol/L低于对照组(21.45±3.05)μmol/L(t=10.174、7.627、6.951,P<0.05)。两组不良反应发生率对比(χ^(2)=0.300,P=0.584)。术后3个月,两组生存率为97.06%比90.32%,差异无统计学意义(χ^(2)=0.375,P=0.540);术后6个月,两组生存率94.12%比70.97%,差异有统计学意义(χ^(2)=6.181,P=0.013)。结论载药微球化疗栓塞术治疗中晚期肝癌患者疗效确切,随访6个月患者生存率较高,值得推广。

Objective To investigate the efficacy of chemoembolization with drug-loaded microspheres in patients diagnosed with advanced liver cancer.Methods A total of 65 patients with advanced liver cancer treated between May 2018 and January 2023,were divided into 2 groups based on the surgical method used:control group(31 cases:conventional surgery)and observation group(34 cases:drug-loaded microsphere chemoembolization).The efficacy of these two treatment approaches was compared.Results The level of glutamyltransferase(GGT)in the observation group(28.26±2.62 U/L)was significantly lower compared to the control group(53.99±3.71 U/L).Similarly,the levels of CA19-9(6.84±0.26 U/mL)and AFP(310.87±5.52 ng/ml)were also lower in the observation group than in the control group(459.26±6.18 ng/ml)(t=32.522,P<0.05;t value=60.674,P<0.05;t value=102.256,P<0.05).1 month pose-surgery,the blood concentrations of Ca(2.12±0.14 mmol/L),iPTH(179.56±19.52 pg/mL)and Ca×P product(45.86±3.62 mg^(2)/dL)in the observation group showed a significantly decrease compared to the control group(2.20±0.15 mmol/L,206.84±22.17 pg/mL,51.47±4.26 mg^(2)/dL).Additionally,the level of blood phosphorus(1.56±0.13 mmol/L)was higher in the observation group than in the control group(1.83±0.14 mmol/L),while the product of calcium and phosphorus(45.86±3.62 mg^(2)/dL)was lower in the observation group compared to the control group(51.47±4.26 mg^(2)/dL)(t value=2.224,P<0.05;t value=5.275,P<0.05;t value=5.737,P<0.05;t value=8.062,P<0.05).Moreover,one month after the operation,the levels of ALT(44.26±3.52 U/L),AST(36.85±5.14 U/L),and Tbil(16.56±2.62)μmol/L were lower than those in the control group(53.97±4.17 U/L,48.10±6.71 U/L,21.45±3.05μmol/L,respectively).(t=10.174,P<0.05;t value=7.627,P<0.05;t value=6.951,P<0.05).The incidence of adverse reactions between the two groups was compared(χ^(2)=0.300,P=0.584).Survival rates at 3 month(χ^(2)=0.375,P=0.540)and 6 months(χ^(2)=6.181,P=0.013)after surgery were also compared.Conclusion Chemoembolization with drug-loaded microspheres has demonstrated effectiveness in the treatment advanced liver cancer patients,with a high survival rate observed at 6 months post-surgery.This treatment approach warrants further investigation and potential application in clinical practice.