经导管肝动脉化疗栓塞联合甲磺酸阿帕替尼在中晚期肝细胞癌中的应用

摘要

Objective To investigate the clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with mesylate apatinib in the treatment of advanced hepatocellular carcinoma.Methods Total of 114 patients with advanced hepatocellular carcinoma (HCC) in Shunde Hospital,Southern University from February 2013 to January 2016 were selected as the research objects and were divided into 3 groups by random number table,38 cases in each group.Patients in group A were treated with TACE,patients in group B were treated with mesylate apatinib and patients in group C were treated with TACE + mesylate apatinib.The efficacy of the three groups were analyzed.Results Before treatment,there was no significant difference in the levels of serum vascular endothelial growth factor (VEGF) and matrix metalloprotein 9 (MMP-9) among the 3 groups (P ＞ 0.05),and after treatment,the levels of serum VEGF and MMP-9 of the three groups were significantly different (P ＜ 0.05).The survival rate of group A,group B and group C were 34.12％,28.95％ and 60.52％ after treatment for 6 months,respectively,the differences were statistically significant (x2 =21.333,P ＜ 0.001).The survival rate of group A,group B and group C were 21.05％,15.79％ and 42.10％ after treatment for 12 months,respectively,the differences were statistically significant (x2 =7.600,P =0.022).The rate of disease control in group A,group B and group C were 23.68％,23.68％ and 50.00％,the differences were statistically significant (x2 =8.003,P =0.018).There was no significant difference in the incidence of adverse reactions among the 3 groups (x2 =1.416,P =0.493).Conclusion The clinical effect of TACE combined with mesylate apatinib in the treatment of patients with advanced hepatocellular carcinoma was significant and the tumor cells were effectively inhibited.%目的 讨论经导管肝动脉化疗栓塞联合甲磺酸阿帕替尼治疗中晚期肝细胞癌(hepatocellular carcinoma,HCC)的临床疗效.方法 选取2013年2月至2016年1月南方大学顺德医院收治的中晚期肝细胞癌患者114例为研究对象,采用随机数字表法分为3组,每组38例.其中A组患者仅使用经导管肝动脉化疗栓塞进行治疗,B组患者仅给予甲磺酸阿帕替尼治疗,C组患者给予经导管肝动脉化疗栓塞联合甲磺酸阿帕替尼治疗,对3组中晚期HCC患者的治疗效果进行分析.结果 治疗前,3组HCC患者血清(vascular endothelial growth factor,VEGF)和(matrix metalloprotein 9,MMP-9)水平差异无统计学意义(P＞0.05);治疗后,C组患者VEGF、MMP-9水平显著低于A、B组(P＜0.05).治疗6个月后,A组、B组和C组患者的生存率分别为34.12％、28.95％和60.52％,差异有统计学意义(x2=21.333,P＜ 0.001);治疗12个月后,A组、B组和C组的生存率分别为21.05％、15.79％和42.10％,差异有统计学意义(x2=7.600,P＜0.05).A组、B组和C组的疾病控制率分别为23.68％、23.68％和50.00％,差异有统计学意义(x2=8.003,P=0.018).3组HCC患者的不良反应发生率无显著差异(x2=1.416,P=0.493).结论 中晚期肝细胞癌患者采用经导管肝动脉化疗栓塞联合甲磺酸阿帕替尼治疗的临床效果显著,患者肿瘤进展得到有效抑制.