肝内胆管癌根治性切除术联合阿帕替尼治疗肝内胆管癌的临床效果

Clinical Efficacy of Radical Resection of Intrahepatic Cholangiocarcinoma Combined with Apatinib in the Treatment of Intrahepatic Cholangiocarcinama

目的探讨根治性肿瘤切除术联合阿帕替尼对肝内胆管癌患者的治疗效果及安全性。方法选取商丘市第三人民医院2017年12月1日至2020年2月1日收治的肝内胆管癌患者作为研究对象,根据患者是否接受分子靶向药物治疗,将患者分为试验组(手术联合阿帕替尼治疗)及对照组(手术治疗)。通过对比分析两组患者术后总体生存率、肿瘤复发/转移率及两组患者随访期间血常规、肝功能水平,明确根治性肿瘤切除术联合阿帕替尼对肝内胆管癌患者的治疗效果及安全性。结果两组患者血常规、肝功能、肿瘤标志物、肿瘤分化程度等一般资料差异无统计学意义(P>0.05)。术后6个月试验组患者天门冬氨酸氨基转移酶、甲胎蛋白、糖类抗原19-9、癌胚抗原低于对照组(P<0.05)。试验组患者术后复发/转移率低于对照组(P=0.028)。在不良反应上,试验组仅有2例患者出现腹泻(4.44%),1例患者出现呕吐(2.22%),2例患者出现乏力(4.44%),各类药物相关不良反应发生率均较低。随访观察显示两组患者整体生存率差异无统计学意义(P>0.05)。结论根治性肿瘤切除术后的肝内胆管癌患者接受阿帕替尼治疗可以在一定程度上延缓肿瘤的复发/转移,且对患者耐受性良好。

Objective To investigate the therapeutic effect and safety of radical tumor resection combined with apatinib in patients with intrahepatic cholangiocarcinoma.Methods Patients with intrahepatic cholangiocarcinoma admitted to the Third People’s Hospital of Shangqiu from December 1,2017 to February 1,2020 were selected as study subjects,and patients were divided into experimental group(surgery combined with apatinib treatment)and control group(surgery treatment)according to whether they received molecular targeted drug therapy or not.By comparing and analyzing the overall survival rate after surgery,tumor recurrence/metastasis rate and the blood routine and liver function levels during the follow-up period of patients in both groups,the therapeutic effects and safety of radical tumor resection combined with apatinib for patients with intrahepatic cholangiocarcinoma were clarified.Results There were no significant differences in general data such as blood routine,liver function,tumor markers and tumor differentiation between the two groups(P>0.05).6 months after surgery,the levels of aspartate aminotransferase,alpha-fetoprotein,carbohydrate antigen 19-9 and carcinoembryonic antigen in experimental group were lower than those in control group(P<0.05).The postoperative recurrence/metastasis rate of experimental group was lower than that of control group(P=0.028).In terms of adverse reactions,only 2 patients in the experimental group had diarrhea(4.44%),1 patient had vomiting(2.22%),and 2 patients had fatigue(4.44%).The incidence of adverse reactions related to various drugs was low.Follow-up observation showed no significant difference in overall survival rate between the two groups(P>0.05).Conclusion Apatinib therapy in patients with intrahepatic cholangiocarcinoma after radical tumor resection can delay tumor recurrence/metastasis to a certain extent and is well tolerated in patients.