Impact of hepatectomy and postoperative adjuvant transarterial chemoembolization on serum tumor markers and prognosis in intermediate-stage hepatocellular carcinoma

BACKGROUND Primary hepatocellular carcinoma(HCC)is a common malignant tumour,and its early symptoms are often not obvious,resulting in many patients experiencing middle-to late-stage disease at the time of diagnosis.The optimal time for surgery is often missed for these patients,and those who do undergo surgery have unsatisfactory long-term outcomes and a high recurrence rate within five years.Therefore,postoperative follow-up treatments,such as transhepatic arterial chemoembolization(TACE),have become critical to improving survival and reducing recurrence rates.AIM To validate the prophylactic role of TACE after hepatic resection and to assess its impact on patient prognosis.METHODS This study investigated the efficacy of TACE in patients with intermediate-stage HCC after hepatectomy.When the post-treatment results of the observation group and the control group were compared,it was found that the inclusion of TACE significantly improved the clinical efficacy,reduced the levels of tumour markers and did not aggravate the damage to liver function.Thus,this may be an effective and comprehensive treatment strategy for patients with intermediate-stage HCC that helps to improve their quality of life and survival time.RESULTS When the baseline data were analysed,no statistical differences were found between the two groups in terms of gender,age,hepatitis B virus,cirrhosis,Child-Pugh grading,number of tumours,maximum tumour diameter and degree of tumour differentiation.The assessment of clinical efficacy showed that the post-treatment overall remission rate of the observation group was significantly higher than that of the control group.In terms of changes in tumour markers,the alpha-fetoprotein and carcinoembryonic antigen levels in the patients in the observation group decreased more significantly after treatment compared with those in the control group.When post-treatment changes in liver function indicators were analysed,no statistical differences were found in the total bilirubin,alanine aminotransferase and aspartate aminotransferase levels between the two groups.CONCLUSION In patients with intermediate-stage HCC,post-hepatectomy TACE significantly improved clinical outcomes,reduced tumour-marker levels and may have improved the prognosis by removing residual lesions.Thus,this may be an effective and comprehensive treatment strategy for patients with intermediate-stage HCC.

Percutaneous microwave ablation and transcatheter arterial chemoembolization for serum tumor markers and prognostics of middle-late primary hepatic carcinoma

BACKGROUND Primary hepatic carcinoma(PHC)has an insidious onset and is usually diagnosed in the middle and late stages.Although transcatheter arterial chemoembolization(TACE)is the preferred option for treating middle-and advanced-stage PHC,it has limited efficacy in killing tumor cells and poor long-term efficacy.TACE plus percutaneous microwave coagulation therapy(PMCT)is more effective than interventional therapy alone and can improve survival time.However,there are few reports on the effects of TACE and PMCT on serum marker levels and the prognosis of patients with advanced PHC.AIM To investigate the effect of PMCT+TACE on serum tumor markers and the prognosis of middle-late PHC.METHODS This retrospective study included 150 patients with middle-late PHC admitted to Zhongshan People’s Hospital between March 2018 and February 2021.Patients were divided into a single group(treated with TACE,n=75)and a combined group(treated with TACE+PMCT,n=75).Before and after treatment,the clinical efficacy and serum tumor marker levels[carbohydrate antigen 19-9(CA19-9),alpha-fetoprotein(AFP),and carcinoembryonic antigen(CEA)]of both groups were observed.The 1-year survival rates and prognostic factors of the two groups were analyzed.RESULTS The combined group had 21 and 35 cases of complete remission(CR)and partial remission(PR),respectively.The single group had 13 and 25 cases of CR and PR,decreased,with the decrease in the combined group being more significant(P<0.05).The 1-year survival rate of the combined group(80.00%)was higher than that of the single group(60.00%)(P<0.05).The average survival time within 1 year in the combined group was 299.38±61.13 d,longer than that in the single group(214.41±72.97 d,P<0.05).COX analysis revealed that tumor diameter,tumor number,and the treatment method were prognostic factors for patients with middle-late PHC(P<0.05).CONCLUSION TACE+PMCT is effective in treating patients with mid-late PHC.It reduces the levels of tumor markers,prolongs survival,and improves prognosis.

Effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion

Objective:To investigate the effect of arterial interventional chemotherapy before radical operation for gastric cancer on serum tumor markers and cell growth in the lesion.Methods:90 patients with primary gastric cancer who underwent radical operation for gastric cancer in our hospital were chosen as the research subjects and divided into the control group (n=48) (did not receive preoperative arterial interventional chemotherapy) and the arterial interventional chemotherapy group (n=42) (received preoperative arterial interventional chemotherapy). The differences in tumor markers in serum as well as proliferation and apoptosis gene expression in gastric cancer tissues were compared.Results: Before surgery started, serum CA199, CA153, CA724 and AFP levels of arterial interventional chemotherapy group were significantly lower than those immediately after admission whereas serum CA199, CA153, CA724 and AFP levels of control group were not significantly different from those immediately after admission. After surgery, proliferation genes CUL4A and NTSR1 mRNA expression in gastric cancer tissues of arterial interventional chemotherapy group were lower than those of control group whereas DADS and FAM96B mRNA expression were higher than those of control group;apoptosis genes Livin and Bcl-2 mRNA expression were lower than those of control group whereas p53, p21 and Bax mRNA expression were higher than those of control group.Conclusion:Preoperative arterial interventional chemotherapy combined with radical operation for gastric cancer can more effectively inhibit the malignant degree of tumor and delay the growth of cancer cells.

Effects of combined treatment of bronchial arterial chemoembolization and radioactive particle implantation on tumor markers and T lymphocyte subsets in locally advanced non-small cell lung cancer

Objective: To investigate the effects of bronchial arterial chemoembolization combined with radioactive particle implantation on the level of serum tumor markers and T lymphocyte subsets in patients with locally advanced non-small cell lung cancer. Methods: A total of 91 cases of locally advanced non-small cell lung cancer patients according to the random data table were divided into the control group (n=45) and observation group (n=46) according to the random data table. Patients in the control group was treated with bronchial arterial chemoembolization, on the basis of the control group, patients in the observation group were treated with radioactive particle implantation, the serum tumor markers and T lymphocyte subsets of the two groups were compared before and after treatment. Results: The levels of CEA, NSE, CA125, CD4+, CD8+, CD4+/CD8+ and NK in the two groups before the treatment were not statistically significant. Compared with the group before treatment, levels of CEA, NSE, CA125and CD8+ of the two groups after treatment were significantly decreased, and after treatment the level of CEA, NSE, CA125and CD8+ in the observation group was significantly lower than those of the control group;The levels of CD4+, CD4+/CD8+ and NK in the two groups after treatment were significantly higher than those in the group before treatment, and the observation group levels were significantly higher than those of the control group. Conclusion: Bronchial artery embolization combined with radioactive particle implantation for locally advanced non-small cell lung cancer, can effectively reduce the serum tumor markers level, improve the level of T cell subsets of patients, has important clinical value.

Comparative analysis of Nε-carboxymethyl-lysine and inflammatory markers in diabetic and non-diabetic coronary artery disease patients

BACKGROUND Coronary artery disease(CAD)is a major cause of death worldwide,and India contributes to about one-fifth of total CAD deaths.The development of CAD has been linked to the accumulation of Nε-carboxymethyl-lysine(CML)in heart muscle,which correlates with fibrosis.AIM To assess the impact of CML and inflammatory markers on the biochemical and cardiovascular characteristics of CAD patients with and without diabetes.METHODS We enrolled 200 consecutive CAD patients who were undergoing coronary angiography and categorized them into two groups based on their serum glycosylated hemoglobin(HbA1c)levels(group I:HbA1c≥6.5;group II:HbA1c<6.5).We analyzed the levels of lipoproteins,plasma HbA1c levels,CML,interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),and nitric oxide.RESULTS Group I (81 males and 19 females) patients had a mean age of 54.2 ± 10.2 years, with a mean diabetes duration of4.9 ± 2.2 years. Group II (89 males and 11 females) patients had a mean age of 53.2 ± 10.3 years. Group I had moresevere CAD, with a higher percentage of patients with single vessel disease and greater stenosis severity in the leftanterior descending coronary artery compared to group II. Group I also exhibited a larger left atrium diameter.Group I patients exhibited significantly higher levels of CML, TNF-α, and IL-6 and lower levels of nitric oxide ascompared with group II patients. Additionally, CML showed a significant positive correlation with IL-6 (r = 0.596,P = 0.001) and TNF-α (r = 0.337, P = 0.001) and a negative correlation with nitric oxide (r=-4.16, P = 0.001). Oddsratio analysis revealed that patients with CML in the third quartile (264.43-364.31 ng/mL) were significantlyassociated with diabetic CAD at unadjusted and adjusted levels with covariates.

Effect of preoperative hyperselective uterine arterial chemoembolization on the infiltrative growth of cancer cells in locally advanced cervical cancer

Objective:To study the effect of preoperative hyperselective uterine arterial chemoembolization on the infiltrative growth of cancer cells in locally advanced cervical cancer.Methods: Patients with locally advanced cervical cancer who underwent surgical resection in Ankang Municipality Maternity and Child Care between February 2015 and October 2017 were selected and randomly divided into the observation group who received preoperative hyperselective uterine arterial chemoembolization and the control group who received routine preoperative preparation. The contents of tumor markers in serum were determined at diagnosis and 1 day before undergoing surgery;the expression levels of tumor suppressor genes and invasion genes were determined after surgical resection.Results: 1 day before undergoing surgery, serum CA125, TSGF, SCC and HE4 levels of observation group were lower than those at diagnosis whereas serum CA125, TSGF, SCC and HE4 levels of control group were not significant different from those at diagnosis;after surgical resection, RASSF2A, FHIT, eIF4E3, RIZ1, DAPK and Syk protein expression in cervical cancer lesions of observation group were significantly higher than those of control group;whereas RbAp48, Vimentin, N-cadherin, Sox2,β-catenin and MMP9 protein expression were significantly lower than those of control group.Conclusion: Preoperative hyperselective uterine arterial chemoembolization can inhibit the infiltrative growth of cancer cells in locally advanced cervical cancer.

Arterial calcification: Finger-pointing at resident and circulating stem cells

The term "Stammzelle"(stem cells) originally appeared in 1868 in the works of Ernst Haeckel who used it to describe the ancestor unicellular organism from which he presumed all multicellular organisms evolved. Since then stem cells have been studied in a wide spectrum of normal and pathological conditions; it is remarkable to note that ectopic arterial calcification was considered a passive deposit of calcium since its original discovering in 1877; in the last decades, resident and circulating stem cells were imaged to drive arterial calcification through chondro-osteogenic differentiation thus opening the idea that an active mechanism could be at the basis of the process that clinically shows a Janus effect: calcifications either lead to the stabilization or rupture of the atherosclerotic plaques. A review of the literature underlines that 130 years after stem cell discovery, antigenic markers of stem cells are still debated and the identification of the osteoprogenitor phenotype is even more elusive due to tissue degradation occurring at processing and manipulation. It is necessary to find a consensus to perform comparable studies that implies phenotypic recognition of stem cells antigens. A hypothesis is based on the singular morphology and amitotic mechanism of division of osteoclasts: it constitutes the opening to a new approach on osteoprogenitors markers and recognition. Our aim was to highlight all the present evidences of the active calcification process, summarize the different cellular types involved, and discuss a novel approach to discover osteoprogenitor phenotypes in arterial wall.

Effect of selective arterial chemoembolization combined with local radiotherapy on the malignant biological behavior of advanced lung cancer

Objective:To study the effect of selective arterial chemoembolization combined with local radiotherapy on the malignant biological behavior of advanced lung cancer.Methods:A total of 76 patients with advanced lung cancer treated in our hospital between May 2011 and July 2015 were collected, their treatment and related test results were retrospectively analyzed, and then they were divided into the control group who accepted intravenous chemotherapy combined with local radiotherapy and the observation group who accepted selective arterial chemoembolization combined with local radiotherapy. After treatment, immune scatter turbidimetry was used to detect the serum tumor marker levels of both groups, and fluorescence quantitative PCR was used to detect the proliferation, invasion and autophagy gene mRNA expression in lung cancer tissue.Results: After treatment, serum tumor markers CA19-9, CYFRA21-1, GSTP1 and CHI3L1 levels of observation group were significantly lower than those of control group;proliferation genes HOXB7 and TEM8 mRNA expression in lung cancer tissue of observation group were significantly lower than those of control group while TCF21 mRNA expression was significantly higher than that of control group;invasion gene EFEMP1 mRNA expression in lung cancer of observation group was significantly higher than that of control group while PAK4, FoxM1 and NGAL mRNA expression were significantly lower than those of control group;autophagy genes LC3, Beclin-1, pULK, PI3KC3 and MAPLC3 mRNA expression in lung cancer tissue of observation group were significantly higher than those of control group.Conclusion: Selective arterial chemoembolization combined with local radiotherapy can reduce the malignant degree of advanced lung cancer and inhibit lung cancer cell proliferation and invasion.

Effect of systemic intravenous chemotherapy combined with regional arterial perfusion chemoembolization on the malignancy of locally advanced gastric cancer

Objective:To study the effect of systemic intravenous chemotherapy combined with regional arterial perfusion chemoembolization on the malignancy of locally advanced gastric cancer. Methods:A total of 90 patients with primary gastric cancer who received treatment in Tianyou Hospital Affiliated to Wuhan University of Science & Technology between January 2014 and May 2016 were collected and divided into control group and observation group according to the random number table method, 45 cases in each group. The control group of patients received routine systemic intravenous chemotherapy + surgical treatment, and the observation group of patients received systemic intravenous chemotherapy combined with local arterial perfusion chemoembolization + surgical treatment. Levels of tumor markers and angiogenesis factors in serum as well as the expression of oncogenes and tumor suppressor genes in gastric cancer tissue were compared between the two groups of patients before and after chemotherapy.Results:Before chemotherapy, the levels of tumor markers and angiogenesis factors in serum as well as the expression of oncogenes and tumor suppressor genes in gastric cancer tissue were not significantly different between the two groups of patients;after chemotherapy, serum CEA, CA724, CA242, AFP, VEGF, Ang-2, COX2 and PD-ECGF levels of observation group were lower than those of control group, andiASPP, p130Cas, ERBB2 and C-myc mRNA expression in gastric cancer tissue were lower than those of control group while GKN1, p16, PTEN, TSPYL5 and merlin mRNA expression in gastric cancer tissue were higher than those of control group.Conclusions: Preoperative systemic intravenous chemotherapy combined with regional arterial perfusion chemoembolization can effectively reduce the malignancy of locally advanced gastric cancer and provide favorable conditions for the operation.

经导管动脉化疗栓塞术联合微波消融治疗原发性肝细胞癌患者疗效观察

目的观察经导管动脉化疗栓塞术(TACE)联合微波消融治疗原发性肝细胞癌(HCC)对患者血清肿瘤标志物、T淋巴细胞亚群的影响。方法收集2018年10月—2021年12月哈尔滨医科大学附属肿瘤医院介入科收治的原发性HCC患者104例临床资料,随机分为TACE组52例(TACE治疗)、联合组52例(TACE+微波消融治疗),评估术后1个月疗效,比较治疗前后2组患者肝功能指标、血清肿瘤标志物、T淋巴细胞亚群,统计患者并发症发生率。结果联合组总有效率为86.5%,高于TACE组的69.2%(χ^(2)/P=4.522/0.033);治疗后1个月联合组AST、ALT水平低于TACE组(t=10.473、8.602,P均<0.001);AFP水平低于TACE组(t=11.724,P<0.001);CD4^(+)、CD4^(+)/CD8^(+)高于TACE组,CD8^(+)低于TACE组(t=3.913、5.460、5.586,P均<0.001);2组并发症发生率比较差异无统计学意义(P>0.05)。结论原发性HCC患者接受TACE联合微波消融治疗可显著下调其血清肿瘤标志物水平,改善肝功能及免疫功能,提升整体疗效。

不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响

目的观察不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响。方法回顾性选取2020年1月—2022年8月收治的116例大脑中动脉供血区急性脑梗死患者的临床资料进行分析,根据针灸介入时机分为两组。两组均进行静脉溶栓及常规药物治疗,观察组61例患者于发病72 h内给予针灸治疗,对照组55例患者于发病2周时给予针灸治疗。检测两组不同时间点侧支循环代偿情况、脑损伤标志物的水平,评估两组不同时间点简易精神状态检查(Mini-mental state examination,MMSE)评分、神经功能评分、Barthel指数(Barthel index,BI)评分、肢体运动功能评分、中医症状评分的差异,统计两组疗效。结果治疗前,两组侧支循环代偿情况比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组患侧大脑前动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow ve⁃locity of the affected anterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVACA/cVM⁃CA)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组患侧大脑后动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow velocity of the affected posterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVPCA/cVMCA)与治疗前比较,差异无统计学意义(P>0.05)。治疗前,两组脑损伤标志物比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组钙结合蛋白β(Calcium binding proteinβ,S100β)、神经胶质纤维酸性蛋白(Glial fibrillary acid protein,GFAP)较治疗前下降,观察组同时间点较对照组更低(P<0.05)。治疗前,两组Fugl-Meyer评分、中医症状评分等相关评分比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组MMSE评分、BI评分及上肢和下肢Fugl-Meyer评分较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组美国国立卫生院神经功能缺损(National institutes of health stroke scale,NIHSS)评分、中医症状评分较治疗前下降,观察组同时间点较对照组更低(P<0.05)。观察组总有效率为88.52%(54/61)高于对照组的72.73%(40/55),差异有统计学意义(P<0.05)。结论发病72h内采用针灸治疗可改善大脑中动脉供血区急性脑梗死脑损伤标志物的表达,改善脑血流,促进神经功能的恢复,有利于疾病的康复。

肝动脉介入化疗栓塞术在原发性肝癌术后患者中的应用研究

目的探究肝动脉介入化疗栓塞术对原发性肝癌术后患者的疗效。方法选择100例原发性肝癌患者作为观察对象,按随机数字表法分成2组,各50例。两组均于腹腔镜引导行肿瘤切除术,研究组在术后7 d辅以肝动脉介入化疗栓塞术治疗,治疗后随访2年。对比治疗前后两组肝功能[谷草转氨酶(AST)、总胆红素(TBIL)及谷丙转氨酶(ALT)]、血清肿瘤标志物[糖类抗原19-9(CA19-9)、甲胎蛋白(AFP)及磷脂酰肌醇蛋白聚糖-3(GPC3)]水平、生存质量[生命质量测定量表(QOL-LC)],统计两组术后复发率及生存率。结果与治疗前对比,两组治疗后7 d的血清AST、TBIL、ALT水平均增高,且研究组较对照组更高,差异有统计学意义(P<0.05);与治疗前对比,两组治疗后1个月血清CA19-9、AFP、GPC3水平均降低,且研究组较对照组更低,差异有统计学意义(P<0.05);与治疗前对比,治疗后1个月两组QOL-LC评分均增高,且研究组[(185.74±12.34)分]较对照组[(164.30±11.55)分]更高,差异有统计学意义(P<0.05);研究组治疗后2年复发率为26.00%(13/50),低于对照组的50.00%(25/50),生存率为84.00%(42/50),高于对照组的64.00%(32/50),差异有统计学意义(P<0.05)。结论肝动脉介入化疗栓塞术辅助肿瘤切除术治疗原发性肝癌效果更佳,可有效降低血清肿瘤标志物表达水平,改善肺功能及生存质量,提升临床生存率,利于预后。

DEB-TACE与索拉非尼联用治疗中晚期肝细胞肝癌的临床研究

目的:探讨载药微球经导管动脉化疗栓塞术(DEB-TACE)联合索拉非尼对中晚期肝细胞肝癌(HCC)患者血清肿瘤标志物水平及肝功能的影响。方法:选取2020年6月—2022年6月于贵溪市人民医院就诊的中晚期HCC患者120例,采用随机数字表法分为对照组和研究组,各60例。对照组采用传统肝动脉化疗栓塞联合索拉非尼治疗,研究组采用DEB-TACE联合索拉非尼治疗。对比两组治疗3个月后临床疗效;并对比两组治疗前后血清肿瘤标志物[血管内皮生长因子(vascular endothelial growth factor,VEGF)、癌胚抗原(carcinoembryonic antigen,CEA)、甲胎蛋白(alpha fetoprotein,AFP)]水平及肝功能指标[丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)]水平;对比两组无进展生存期(progressive free survival,PFS)、总生存期(overall survival,OS)及不良反应发生情况。结果:研究组客观缓解率(65.00%)明显高于对照组(40.00%),差异有统计学意义(P<0.05)。与对照组比较,研究组治疗后血清VEGF、CEA及AFP水平均更低,差异均有统计学意义(P<0.05)。与对照组比较,研究组治疗后血清AST、ALT及TBIL水平均更低,差异均有统计学意义(P<0.05)。与对照组比较,研究组PFS及OS均明显延长,差异均有统计学意义(P<0.05)。两组各不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:DEB-TACE联合索拉非尼治疗HCC能显著提高中晚期HCC患者的客观缓解率,延长生存时间,调节血清肿瘤标志物水平,降低肝功能损害。

养肺益气汤联合载药微球支气管动脉化疗在非小细胞肺癌治疗中的临床效果分析

目的:分析养肺益气汤联合载药微球支气管动脉化疗治疗非小细胞肺癌的临床效果。方法:选择2020年1月—2023年1月启东市中医院肿瘤科收治的82例非小细胞肺癌患者,根据随机数表法分为化疗组、联用组,各41例。其中化疗组采用载药微球支气管动脉化疗治疗,而联用组采用养肺益气汤联合载药微球支气管动脉化疗治疗。比较两组肿瘤标志物、中医症候积分、毒副作用发生率。结果:治疗前,两组肿瘤标志物比较,差异无统计学意义(P>0.05);治疗后,两组肿瘤标志物均低于治疗前,且联用组低于化疗组,差异有统计学意义(P<0.05)。治疗前,两组中医症候积分比较,差异无统计学意义(P>0.05);治疗后,两组中医症候积分均低于治疗前,且联用组低于化疗组,差异有统计学意义(P<0.05)。联用组毒副作用总发生率低于化疗组,差异有统计学意义(P<0.05)。结论:在针对非小细胞肺癌进行治疗时,在载药微球支气管动脉化疗基础上予以养肺益气汤治疗能够进一步控制癌症病变,缓解各项临床症状,并降低毒副作用发生的可能性。

扶正安中汤联合索拉非尼在中晚期肝癌患者的临床观察

目的:探讨扶正安中汤联合索拉非尼(SOR)治疗肝动脉插管化疗栓塞术(TACE)后中晚期肝细胞癌(HCC)患者的临床效果。方法:选取2021年1至12月亳州市中医院肿瘤科收治的TACE后的中晚期HCC患者100例作为研究对象,用简单随机化分组方法分为对照组和观察组,每组50例。对照组采用SOR治疗,观察组采用SOR联合扶正安中汤治疗,持续治疗3个疗程后予以疗效评估,随访1年;比较2组治疗前后中医证候积分、肝功能、肾功能、肿瘤标志物及炎症介质水平指标;统计1年患者生存情况及用药安全性。结果:对照组和观察组疾病控制率分别为24.00%和56.00%(P<0.05)。治疗后,2组患者中医证候积分、血清指标谷草转氨酶(GOT)、谷丙转氨酶(GPT)、白蛋白(ALB)、总胆红素(TB)较治疗前下降,且对照组高于观察组(均P<0.05);2组患者血清肌酐(Cr)、尿素氮(BUN)较治疗前升高,且对照组低于观察组,但差异无统计学意义(P>0.05)。1年随访期间对照组和观察组生存率分别为24.00%和42.00%,组间差异显著(χ~2=8.72,P=0.0018)。2组血清恶性肿瘤特异性生长因子(TSGF)、血清甲胎蛋白(AFP)、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平较治疗前下降,且对照组高于观察组(P<0.05)。结论:扶正安中汤联合SOR是治疗TACE后中晚期HCC患者的有效方案。相对于单独使用SOR治疗,能有效调节血清肿瘤标志物及炎症介质水平,且不增加药物治疗风险。

低剂量阿帕替尼与S-TACE联合治疗肝癌的临床效果

目的探究低剂量阿帕替尼与超选择性肝动脉化疗栓塞术(S-TACE)联合治疗中晚期原发性肝癌(PLC)的应用价值。方法选取2021年1月—2022年1月自贡市第一人民医院102例中晚期PLC患者,随机分为两组,各51例。对照组采用S-TACE治疗,研究组采用低剂量阿帕替尼联合S-TACE治疗。比较两组治疗效果、血清肿瘤标志物[甲胎蛋白(AFP)、糖类抗原199(CA199)、E-钙黏蛋白(EC)]、免疫功能指标[T淋巴细胞(CD3^(+)、CD4^(+))、CD4^(+)/CD8^(+)]、同源异型蛋白(SIX1、SIX2)水平、不良反应及预后情况。结果研究组术后3个月、6个月总有效率分别为86.27%、82.35%,均高于对照组的64.71%、58.82%(P<0.05);研究组血清AFP、CA199、EC、SIX1、SIX2术后3个月分别为(95.24±23.67)ng/mL、(47.31±8.52)U/L、(1811.24±153.76)ng/mL、(52.71±7.38)ng/mL、(49.83±6.59)ng/mL,术后6个月分别为(101.65±24.83)ng/mL、(50.26±9.41)U/L、(1856.32±160.25)ng/mL、(53.26±7.45)ng/mL、(50.26±6.71)ng/mL,分别低于对照组[(119.86±25.40)ng/mL、(57.46±9.18)U/L、(1923.57±166.02)ng/mL、(60.23±7.69)ng/mL、(57.61±7.02)ng/mL]、[(126.17±26.59)ng/mL、(60.08±9.77)U/L、(1972.43±171.09)ng/mL、(62.11±7.90)ng/mL、(58.19±7.35)ng/mL](P<0.05);研究组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)术后3个月分别为(68.13±7.84)%、(36.48±2.75)%、(1.31±0.23),术后6个月分别为(66.75±8.04)%、(35.67±2.88)%、(1.30±0.22),均高于对照组[(62.35±8.13)%、(33.75±2.91)%、(1.20±0.25)]、[(60.21±8.26)%、(32.86±3.10)%、(1.18±0.26)](P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);术后1年研究组生存率(90.20%)高于对照组(74.51%)(P<0.05)。结论低剂量阿帕替尼与S-TACE联合治疗PLC能增强临床疗效,调节免疫功能,减轻患者病情,有助于改善生存预后,安全性较高。

射频消融与肝动脉化疗栓塞术治疗复发性肝癌的效果对比

目的分析在复发性肝癌治疗中采用射频消融与肝动脉化疗栓塞术改善肝癌肿瘤标志物水平的效果。方法前瞻性随机选取2020年1月—2023年1月福建省漳州市医院收治的60例复发性肝癌患者为研究对象,按随机数表法将其分为观察组和对照组,各30例。对照组患者采用肝动脉化疗栓塞术治疗,观察组采用射频消融治疗。比较两组复发性肝癌患者治疗总有效率、治疗期间不良反应发生情况以及治疗前后肝癌肿瘤标志物(异常凝血酶原、糖类抗原199、甲胎蛋白)水平改善情况。结果两组术前肝癌肿瘤标志物水平对比,差异无统计学意义(P均>0.05);术后两组异常凝血酶原、糖类抗原199、甲胎蛋白平均明显改善,且观察组优于对照组,差异有统计学意义(P均<0.05)。观察组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(χ^(2)=4.320,P=0.037)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论射频消融治疗复发性肝癌的效果优于肝动脉化疗栓塞术,更有利于控制患者病情,改善肿瘤标志物的表达。

仑伐替尼联合肝动脉化疗栓塞术对肝癌患者肿瘤标志物、免疫功能的影响

目的分析仑伐替尼联合肝动脉化疗栓塞术(TACE)治疗肝癌的临床效果及对肿瘤标志物、免疫功能相关分子的影响。方法商丘市立医院2021年1月至2023年7月肝癌患者76例作为研究对象,以不同治疗方案分为对照组、联合组,各38例。对照组予以TACE治疗,联合组予以仑伐替尼联合TACE治疗。连续治疗2个月后,比较两组疗效,不良反应,生存情况,肿瘤标志物[甲胎蛋白(AFP)、糖类抗原199(CA199)、α-L-岩藻糖苷酶(AFU)、癌胚抗原(CEA)]及免疫分子[Toll样受体2(TLR 2)、TLR 4、髓样分化因子88(MyD 88)]。结果治疗2个月后联合组病情控制率(DCR)为78.95%,高于对照组57.89%(P<0.05),联合组客观缓解率(ORR)为42.11%,与对照组的26.32%相比,差异无统计学意义(P>0.05)。治疗2个月后,联合组AFP、CA199、AFU、CEA低于对照组(P<0.05);联合组TLR2、TLR4、MyD88低于对照组(P<0.05)。两组疼痛、疲乏、腹泻、血小板下降、高血压、蛋白尿、手足综合征等不良反应发生率相比,差异无统计学意义(P>0.05);联合组发热发生率(15.79%)低于对照组(36.84%)(P<0.05);联合组中位总生存时间(OS)、中位无进展生存(PFS)高于对照组(P<0.05)。结论仑伐替尼联合TACE治疗肝癌疗效确切,能改善免疫功能紊乱及肿瘤标志物水平,提高ORR,增加OS、PFS,且不良反应可控。

平喘止咳汤对慢阻肺急性加重期患者炎症标志物水平和动脉血气指标的影响

目的探究平喘止咳汤对痰热郁肺型慢阻肺急性加重期患者炎症标志物水平和动脉血气指标的影响。方法按随机数表法将2019年7月至2021年9月期间于开封市中医院肺病科且病房住院就诊的80例痰热郁肺型慢阻肺急性加重期患者分为观察组和对照组各40例。对照组患者接受常规西医治疗,持续治疗一周,观察组患者在对照组治疗的基础上接受平喘止咳汤治疗,连续服用一周。治疗前和治疗一周后比较两组患者的中医症状积分、炎症标志物水平[血清血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、γ干扰素(IFN-γ)]、动脉血气指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧饱和度(SaO_(2))]和疾病严重程度[慢性阻塞性肺疾病评测量表(CAT)],同时比较两组患者治疗期间的不良反应发生情况。结果治疗前,两组患者的中医证候积分、炎症标志物水平、动脉血气指标和CAT评分比较差异均无统计学意义(P>0.05);治疗一周后,两组患者的中医证候积分较治疗前显著降低,且观察组[主症(5.48±1.07)分、次症(4.30±0.85)分、舌脉(2.05±0.23)分]明显低于对照组[主症(7.53±1.61)分、次症(5.75±1.11)分、舌脉(2.55±0.40)分],差异均有统计学意义(P<0.05);治疗一周后,两组患者的PCT、hs-CRP、IL-6和IFN-γ水平均较治疗前明显降低,且观察组[(0.28±0.09)ng/mL、(8.82±2.89)mg/L、(2.98±0.57)pg/mL、(8.94±2.27)ng/mL]明显低于对照组[(0.44±0.06)ng/mL、(14.55±3.25)mg/L、(3.29±0.61)pg/mL、(14.22±3.27)ng/mL],差异均有统计学意义(P<0.05);治疗一周后,两组患者的PaO_(2)和SaO_(2)水平较治疗前明显提高,且观察组分别为(68.87±4.48)mmHg、(92.33±1.84)%,明显高于对照组的(61.71±4.13)mmHg、(90.01±1.11)%,但两组患者的PaCO_(2)值均较治疗前明显降低,且观察组为(39.89±3.06)mmHg,明显低于对照组的(45.35±3.13)mmHg,差异均有统计学意义(P<0.05)。治疗一周后,两组患者的CAT评分较治疗前显著降低,且观察组为(12.60±2.56)分,明显低于对照组的(17.50±2.70)分,差异均有统计学意义(P<0.05);治疗期间,观察组患者的不良反应总发生率为7.5%,略低于对照组的10.0%,但差异无统计学意义(P>0.05)。结论平喘止咳汤治疗痰热郁肺型慢阻肺急性加重期的效果显著,其不仅能有效降低中医症状积分,缓解疾病严重程度,还可改善患者炎症标志物水平和改善动脉血气指标,促进患者康复。

表柔比星联合奥沙利铂和氟尿嘧啶经导管动脉栓塞化疗用于原发性肝癌患者的效果

目的:观察表柔比星联合奥沙利铂和氟尿嘧啶经导管动脉栓塞化疗用于原发性肝癌患者的效果。方法:选取2021年1月至2023年1月该院收治的122例原发性肝癌患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各61例。对照组采用奥沙利铂联合氟尿嘧啶经导管动脉栓塞化疗,研究组在对照组的基础上联用注射用盐酸表柔比星进行经导管动脉栓塞化疗,比较两组客观缓解率(ORR)、血清肿瘤标志物[脊椎蛋白2(SPON2)、癌胚抗原]水平、血清肝功能指标[丙氨酸氨基转移酶(ALT)、总胆红素、白蛋白]水平、卡氏功能状态评分和不良反应发生率。结果:研究组ORR为86.89%,明显高于对照组的72.13%,差异有统计学意义(P<0.05);治疗8周后,研究组血清白蛋白水平和卡氏功能状态评分均高于对照组,血清癌胚抗原、SPON2、总胆红素和ALT水平低于对照组,差异均有统计学意义(P<0.05);两组恶心呕吐、脱发、白细胞降低等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:表柔比星联合奥沙利铂和氟尿嘧啶经导管动脉栓塞化疗用于原发性肝癌患者可提高ORR、卡氏功能状态评分和血清白蛋白水平,降低血清癌胚抗原、SPON2、总胆红素和ALT水平,效果优于单纯奥沙利铂联合氟尿嘧啶经导管动脉栓塞化疗。