肝癌TACE中化疗和栓塞与肿瘤抑制和肝损伤关系的临床研究

王艳红; 张哲; 乐凡; 周小芸

肝癌TACE中化疗和栓塞与肿瘤抑制和肝损伤关系的临床研究

详细信息

中图分类号: R735.7
计量
- 文章访问数: 2303
- HTML全文浏览量: 17
- PDF下载量: 903
- 被引次数: 0
出版历程
- 出版日期: 2008-04-20

Effect of chemotherapeutics and embolization on tumor inhibition and liver injury in TACE treatment of hepatic carcinoma

摘要

摘要: 目的研究肝癌TACE中化疗与栓塞的并用与否对肿瘤抑制和肝损伤的影响。方法回顾性分析152例HCC患者接受化疗灌注(A组30例)、栓塞(B组29例)或化疗栓塞(C组93例)后1天和4天,AFP下降及肝功能各指标变化。结果(1)AFP下降人数,B组(56.5%,78.3%)和C组(67%,80.7%)显著大于A组(25%,25%)(P<0.001)。(2)肝功能异常人数增幅表现为:TBil,A、C组明显高于B组(P<0.001)。ALT及ALB,B、C组明显大于A组(P<0.005)。PA,C组明显高于A、B组(P<0.005)。结论TACE对肿瘤的抑制主要归功于肿瘤供血血管的栓塞作用;加用肝动脉化疗灌注后,肝损伤的增加明显大于对肿瘤的抑制。
- 原发性肝癌 /
- TACE /
- AFP /
- 肝损伤 /
- 肿瘤抑制
Abstract: Objective To discuss the effect of chemotherapeutics and embolization on tumor inhibition and liver injury in TACE treatment of hepatic carcinoma.Methods AFP and liver function were investigated and evaluated in 152 HCC patients who had been treated by TAC (group A, n=30) or TAE (group B, n=29) or TACE (group C, n=93) without extra-liver metastasis.Results At the 1std and 4thd after TACE, (1) the rate of AFP decrease were higher in group B (56.5%, 78.3%) and group C (67%, 80.7%) than that in group A (25%, 25%) , P<0.01. (2) the abnormal rate amplification, bilirubin total was higher in group A (119.54%, 116.1%) and group C (157.8%, 140%) than that in group B (41.3%, 28%) , P<0.001.ALT and ALB were higher both in group B and group C than that in group A, P<0.005.Pre-albumin was higher in group C (17.5%, 114.4%) than that in group A (3.3%, 0) and group B (3.5%, 29.4%) , P<0.005.Conclusion It is chemoembolization that play an important role in tumor inhibitory action in TACE treatment.The increase of chemotherapeutics dosage accompanied exacerbation of liver injury.It suggested that the control of best combining site both increase tumor inhibitory action and decrease liver injury is key point to evaluate therapeutic effect of TACE.
- HCC /
- TACE /
- AFP /
- Liver injury /
- Tumorinhibition

HTML全文

参考文献(13)

[1]王艳红, 叶胜龙, 张博恒.肝癌的手术切除及介入和射频治疗对肝功能影响的临床研究[J].临床肝胆病杂志, 2005, 21 (6) ∶378-379.

[2]Castaneda F, Kinne RK.Effects of doxorubicin, mitomycin C, andethanol on Hep-G2 cells in vitro[J].J Cancer Res Clin Oncol, 1999, 125 (1) ∶1-8.

[3]Solomonn B, Soulen MC, Baum RA, et al.Chemoembolization ofhepatocellular carcinoma with cisplatin, doxorubidn, mitomycin-C, ethiodol, and polyvinyl alcohol:prospective evaluation of responseand survival in a U.S.population[J].J Vasc Intervent Radiol, 1999, 10∶793-798.

[4]朱康顺, 单鸿, 黄明声, 等.肝癌化疗栓塞后血清肝纤维化指标的含量变化及临床意义[J].临床放射学杂志, 2000, 19∶208-210.

[5]孔健, 窦永充, 许林锋, 等.肝动脉化疗栓塞术治疗原发性肝癌后肝纤维化指标的改变[J].中华肝胆外科杂志, 2002, 8∶414-416.

[6]胡道予, 李震, 吴剑宏, 等.肝癌介入治疗后肝细胞凋亡和再生的研究[J].中华实验外科杂志, 2002, 19∶533-534.

[7]卢伟, 李彦豪, 李祖国, 等.小剂量和常规剂量化疗药物经导管动脉内化疗栓塞后肝癌细胞坏死及凋亡的比较研究[J].中华放射学杂志, 2003, 37∶232-237.

[8]Lu W, Li Y, He X, et al.Transcatheter arterial chemoembolizationfor hepatocellular carcinoma in patients with cirrhosis:evaluation oftwo kinds of dosages of anticancer drugs and analysis of prognosticfactors[J].Hepatogastroenterology, 2003, 50∶2079-2081.

[9]Farinati F, De Maria N, Marafin C, et al.Unresectable hepatocellu-lar carcinoma in cirrhosis:survival, prognostic factors, and unex-pected side effects after ranscatheter arterial chemoembolization[J].Dig Dis Sci, 1996, 41∶2332-2339.

[10]Kamada K, Nakanishi T, Kitamoto M, et al.Long-term prognosisof patients undergoing transcatheter arterial chemoembolization for un-resectable hepatocellular carcinoma:comparison of cisplatin lipiodolsuspension and doxorubicin hydrochloride emulsion[J].J Vasc Inter-vent Radiol, 2001, 12∶847-854.

[11]卢伟, 李彦豪, 何晓峰, 等.小剂量与常规剂量化疗药物经导管栓塞化疗对肝癌患者血清肝纤维化指标的影响[J].介入放射学杂志, 2004, 13∶247-249.

[12]Camma C, Schepis F, Orlando A, et al.Transarterial chemoembo-lization for unresectable hepatocellular carcinoma meta-analysis ofrandomizedc ontroledtrials[J].Radiology, 2002, 224∶47-54.

[13]卢伟, 李彦豪.肝细胞癌经导管化疗栓塞治疗[J].临床放射学杂志, 2002, 21∶735-737.

施引文献

资源附件(0)

访问统计