索拉非尼治疗原发性肝癌的效果及对患者血清血管内皮生长因子受体2、胎盘生长因子水平的影响

摘要

目的 探究索拉非尼治疗原发性肝癌(PHC)的临床效果及其对患者血清血管内皮生长因子受体(VEGFR)2和胎盘生长因子(PLGF)水平的影响.方法 选取2014年7月-2016年3月在复旦大学附属金山医院接受治疗并确诊为PHC的患者110例,随机分为试验组和对照组,每组各55例.对照组给予常规治疗,试验组在常规治疗的基础上服用索拉非尼.采用ELISA检测2组患者血清VEGFR-2、PLGF水平,收集患者肝功能指标(AST、PT、TBil、Alb、ALT).计量资料2组间比较采用独立样本t检验,组内干预前、后比较采用配对样本t检验;计数资料2组间比较采用χ2检验.结果 试验组患者治疗后血清VEGFR-2、PLGF水平与治疗前相比均显著下降[(7053.2±1836.1)ng/L vs(8721.4±2427.8)ng/L,t=4.089,P<0.001;(468.4±136.5)pg/ml vs(656.8±191.4)pg/ml,t=5.975,P<0.001];试验组治疗后VEGFR-2、PLGF水平均显著低于对照组患者治疗后水平[(7053.2±1836.1)ng/L vs(8097.5±2325.4)ng/L,t=2.64,P<0.05;(468.4±136.5)pg/ml vs(643.3±195.8)pg/ml,t=2.48,P<0.05];试验组患者治疗前后AST、ALT水平比较差异均有统计学意义(t值分别为4.302、3.097,P值均<0.05),治疗后试验组患者AST、ALT水平均显著低于对照组治疗后水平(t值分别为2.56、2.39,P值均<0.05).与对照组相比,试验组患者随访结果较好,患者病情控制率增加,差异有统计学意义(27.3%vs 47.3%,χ2=4.705,P=0.030);40个月试验组患者治疗后总生存率较高(43.6%vs 69.1%,χ2=7.245,P=0.007).结论 索拉非尼对PHC患者的治疗结果较好,可显著降低患者血清VEGFR-2、PLGF水平,并且可以显著增长患者确诊后的生存时间和预后效果.%To investigate the clinical efficacy of sorafenib in the treatment of primary hepatic carcinoma (PHC) and its effects on serum vascular endothelial growth factor receptor -2 (VEGFR -2) and placental growth factor (PLGF) levels.Methods A total of 110 patients with a confirmed diagnosis of PHC who received treatment in Jinshan Hospital Affiliated to Fudan University from July 2014 to March 2016 were randomly and equally divided into observation group and control group .The control group was given routine treatment, while the observation group received sorafenib in addition to the routine treatment .Serum levels of VEGFR -2 and PLGF were measured by ELISA.Liver function parameters, aspartate aminotransferase (AST), prothrombin time (PT), total bilirubin (TBil), albumin (Alb), and alanine aminotransferase (ALT), were also recorded.Comparison of continuous data between groups was made by independent samples t -test, and the changes in continuous data after intervention in each group were evaluated by paired samples t -test.Comparison of categorical data between groups was made by chi -square test.Results The observation group showed significant reductions in serum VEGFR -2 and PLGF levels after treatment (VEGFR -2: 7053.2 ±1836.1 ng/L vs 8721.4 ±2427.8 ng/L, t =4.089, P <0.001; PLGF: 468.4 ±136.5 pg/ ml vs 656.8 ±191.4 pg/ml, t =5.975, P <0.001).After treatment, the observation group had significantly lower serum VEGFR -2 and PLGF levels than the control group (VEGFR -2: 7053.2 ±1836.1 ng/L vs 8097.5 ±2325.4 ng/L, t =2.64, P <0.05; PLGF: 468.4 ± 136.5 pg/ml vs 643.3 ±195.8 pg/ml, t =2.48, P <0.05).The observation group showed significant changes in serum AST and ALT lev - els after treatment (t =4.302 and 3.097, both P <0.05).After treatment, the observation group had significantly lower serum AST and ALT levels than the control group (t =2.56 and 2.39, both P <0.05).Compared with the control group, the observation group had better follow -up results, with a significantly increased disease control rate (27.3% vs 47.3% , χ2 =4.705, P =0.030), and had a significantly higher survival rate at 40 months after treatment (43.6% vs 69.1%, χ2 =7.245, P =0.007).Conclusion Sorafenib is effective in the treatment of PHC patients, as it can significantly reduce the serum levels of VEGFR -2 and PLGF, prolong the survival time of patients, and improve the prognosis of patients.