[1]李　靖,肖金成,郑　琳,等.肝动脉栓塞化学治疗与肝动脉栓塞治疗原发性肝癌疗效比较[J].新乡医学院学报,2018,35(11):981-984.[doi:10.7683/xxyxyxb.2018.11.008]
　LI Jing,XIAO Jing-cheng,ZHENG Lin,et al.Comparison of the effect of transcatheter arterial embolization and transcatheter arterial chemoem-bolization in treatment of primary liver cancer[J].Journal of Xinxiang Medical University,2018,35(11):981-984.[doi:10.7683/xxyxyxb.2018.11.008]
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肝动脉栓塞化学治疗与肝动脉栓塞治疗原发性肝癌疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年11
页码:
981-984
栏目:
临床研究
出版日期:
2018-11-05

文章信息/Info

Title:
Comparison of the effect of transcatheter arterial embolization and transcatheter arterial chemoem-bolization in treatment of primary liver cancer
作者:
李　靖; 肖金成; 郑　琳; 余　朴; 黎海亮
（郑州大学附属肿瘤医院微创介入科，河南　郑州　450003）
Author(s):
LI Jing; XIAO Jing-cheng; ZHENG Lin; YU Pu; LI Hai-liang
（Department of Intervention Radiology，the Affiliated Tumor Hospital of Zhengzhou University，Zhengzhou 450003，Henan Province，China）
关键词:
肝动脉栓塞; 肝动脉栓塞化学治疗; 原发性肝癌; 介入治疗
Keywords:
transcatheter arterial embolization; transcatheter arterial chemoembolization; primary liver cancer; interventional therapy
分类号:
R735.7
DOI:
10.7683/xxyxyxb.2018.11.008
文献标志码:
A
摘要:
目的　比较肝动脉栓塞化学治疗（TACE）与肝动脉栓塞（TAE）治疗原发性肝癌（PLC）的临床效果。方法　选择2015年6月至2017年6月郑州大学附属肿瘤医院收治的中晚期PLC患者107例为研究对象，根据治疗方法分为TAE组（n=59）和TACE组（n=48），TAE组患者给予聚乙烯醇栓塞微球和碘油选择性肝肿瘤供血动脉栓塞治疗，TACE组患者给予聚乙烯醇栓塞微球、碘油和化学治疗药物混合乳剂选择性肝肿瘤供血动脉栓塞治疗；对2组患者治疗前及治疗后1、4周血清丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）、白蛋白（ALB）、甲胎蛋白（AFP）水平进行比较；治疗后4周，依据实体瘤疗效评价标准进行疗效评估；并对2组患者不良反应发生率及术后3、6、9、12个月生存率进行比较。结果　治疗前2组患者血清ALT、AST、TBIL、ALB及AFP水平比较差异均无统计学意义（P>0.05）。治疗后1周，TAE组患者血清ALT、AST、TBIL、ALB水平显著低于TACE组（P<0.05），但2组患者血清AFP水平比较差异无统计学意义（P>0.05）。治疗后4周，TAE组患者血清AST水平显著低于TACE组，但2组患者血清ALT、TBIL、ALB及AFP水平比较差异均无统计学意义（P>0.05）。TAE组和TACE组患者治疗有效率分别为76.3%（45/59）、77.1%（37/48），2组患者治疗有效率比较差异无统计学意义（χ2=0.046，P>0.05）。TAE组和TACE组患者不良反应发生率分别为71.19%（42/59）和79.16%（38/48），TACE组患者不良反应发生率高于TAE组（χ2=4.236，P<0.05）。TAE组患者3、6、9、12个月时生存率分别为100.00%（59/59）、93.75%（55/59）、78.13%（46/59）、65.62%（38/59），TACE组患者3、6、9、12个月时生存率分别为100.00%（48/48）、88.88%（43/48）、72.23%（34/48）、63.89%（31/48），2组患者3、6、9、12个月时生存率比较差异均无统计学意义（χ2=0.000、0.128、0.209、0.087，P>0.05）。结论　TAE和TACE治疗PLC的临床疗效及患者3、6、9、12个月生存率相当，但TAE可避免化学治疗药物引起的不良反应，提高患者的耐受性，给不能耐受化学治疗不良反应的患者提供了介入治疗机会。
Abstract:
Objective　To compare the clinical effect of transcatheter arterial embolization （TAE） and transcatheter arterial chemoembolization （TACE） in the treatment of primary liver cancer （PLC）.Methods　A total of 107 patients with advanced PLC in the Affiliated Tumor Hospital of Zhengzhou University from June 2015 to June 2017 were selected as the subjects.The patients were divided into TAE group （n=59） and TACE group （n=48） according to the therapeutic method.The patients in TAE group were treated with selective embolization of liver tumor feeding arteries with polyvinyl alcohol microsphere and lipiodol，and the patients in TACE group were treated with selective embolization of liver tumor feeding arteries with the mixed emulsion of polyvinyl alcohol microsphere，lipiodol and chemotherapeutics.The levels of serum alanine aminotransferase （ALT），aspartate aminotransferase （AST），total bilirubin （TBIL），albumin （ALB） and alpha-fetoprotein （AFP） were compared between the two groups before and 1，4 weeks after therapy.The curative effect was evaluated according to the evaluation criteria in solid tumor at 4 weeks after treatment.The incidence of adverse reactions and the 3-，6-，9- and 12-month survival rate were compared between the two groups.Results　There was no significant difference in serum ALT，AST，TBIL，ALB and AFP levels between the two groups before treatment （P>0.05）.One week after treatment，the serum ALT，AST，TBIL and ALB levels in TAE group were significantly lower than those in TACE group （P<0.05），but there was no significant difference in serum AFP level between the two groups （P>0.05）.Four weeks after treatment，the serum AST level in TAE group was significantly lower than that in TACE group，but there was no significant difference in serum ALT，TBIL，ALB and AFP levels between the two groups （P>0.05）.The effective rate in TAE group and TACE group was 76.3% （45/59） and 77.1% （37/48），respectively.There was no significant difference in the effective rate between the two groups （χ2=0.046，P>0.05）.The incidence of adverse reactions in TAE group and TACE group was 71.19% （42/59） and 79.16% （38/48），respectively.The incidence of adverse reactions in TACE group was higher than that in TAE group （χ2=4.236，P<0.05）.The survival rate of 3-，6-，9- and 12-month in TAE group was 100.00% （59/59），93.75% （55/59），78.13% （46/59） and 65.62% （38/59），respectively.The survival rate of 3-，6-，9- and 12-month in TACE group was 100.00% （48/48），88.88% （43/48），72.23% （34/48） and 63.89% （31/48），respectively.There was no significant difference in the survival rate of 3-，6-，9- and 12-month between the two groups （χ2=0.000，0.128，0.209，0.087；P>0.05）.Conclusion　The clinical efficacy of TAE and TACE in the treatment of PLC and the survival rate of 3-，6-，9- and 12-month are similar，but TAE could avoid the adverse reactions caused by chemotherapeutics，improve the patient′s tolerance，and create the opportu-nity for interventional therapy for the patients who can not tolerate the adverse reactions of chemotherapy.

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更新日期/Last Update: 2018-11-05