摘要
[目的]探究肝癌微波消融术前行肝动脉灌注化疗栓塞(transhepatic arterial chemoembolization,TACE)介入治疗原发性肝癌(primary liver cancer,PLC)的临床效果及对患者脆性组氨酸三联体(fragile histidine triad,FHIT)和P16蛋白表达的影响。[方法]选取2016年3月～2018年3月我院收治的81例PCL患者,分成对照组(n=39)和观察组(n=42),对照组术前未进行化疗,观察组术前行TACE化疗,对2组患者临床疗效、肝功能及坏死面积、肿瘤直径、平均住院时间、病理分期、FHIT、P16蛋白表达、生活质量评分、近期生存率、复发率和不良反应发生情况进行比较。[结果]观察组的治疗总有效率为94.0%,显著高于对照的80.0%(P<0.05)。2组患者总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸转氨酶(ALT)均显著降低,而白蛋白(ALB)显著上升,且观察组更优于对照组(P<0.05)。术后,2组患者FHIT及P16蛋白表达均上升,且观察组更高于对照组(P<0.05)。术后半年,观察组患者生活质量评分、生存率显著高于对照组,复发率显著低于对照组(P<0.05)。[结论]肝癌消融术前行肝动脉灌注介入治疗可为手术切除肿瘤病灶创造更好地条件,治疗后FHIT、P16蛋白表达升高对抑制肝癌细胞生长、提升患者近期生存率、降低不良反应发生率具有重要意义。
[Objective]To investigate the clinical effect of transhepatic arterial chemoembolization(TACE)in the treatment of primary liver cancer(PLC)before the microwave ablation of liver cancer and its effect on the fragile histidine triad(fragile histidine triad,FHIT)and P16 protein expression in patients with liver cancer.[Methods]81patients with PCL admitted to our hospital from March 2016 to March 2018 were enrolled in this study.They were divided into control group(n=39)and observation group(n=42).The control group did not receive chemotherapy before surgery,and the observation group underwent TACE chemotherapy before surgery.The clinical efficacy,liver function and necrotic area,tumor diameter,mean hospital stay,pathological stage,FHIT,P16 protein expression,quality of life score,short-term survival rate,recurrence rate and adverse reaction were compared between the two groups.[Results]The total effective rate of the observation group was 94.0%,which was significantly higher than that of the control(80.0%)(P<0.05).The total bilirubin(TBIL),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)were significantly decreased in both groups,while albumin(ALB)was significantly increased in both groups,and the observation group was superior to the control group(P <0.05).After operation,the expression of FHIT and P16 protein in both groups increased,and the observation group was higher than the control group(P<0.05).The quality of life score and survival rate of patients in the observation group were significantly higher than those in the control group six months after operation,and the recurrence rate in the observation group was significantly lower than that in the control group(P<0.05).[Conclusion]Interventional hepatic artery perfusion before hepatic ablation can create better conditions for surgical resection of tumor lesions.Increased expression of FHIT and P16 protein after treatment is important for inhibiting the growth of hepatoma cells,improving the survival rate of patients and reducing the incidence of adverse reactions.significance.
作者
张流
王军
熊华刚
ZHANG Liu;WANG Jun;XIONG Hua-gang(Department of Liver Diseases,Guiyang Public Health Center,Guiyang 550004,China)
出处
《中国中西医结合消化杂志》
CAS
2019年第1期11-15,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
国家科技重大专项项目(No:2015ZX10100048-001-002)
关键词
肝动脉灌注化疗栓塞
脆性组氨酸三联体
P16
近期疗效
肝肿瘤
transcatheter arterial chemoembolization
fragile histidine triad
P16
short-term efficacy
liver cancer
作者简介
通讯作者:张流,E-mail:247038214@qq.com.
